Individual
MRS. TAMMY LYNN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
706 BRATLEY DRIVE, WASHBURN, WI 54891
(715) 373-6425
(715) 373-5655
Mailing address
706 BRATLEY DRIVE, WASHBURN, WI 54891
(715) 373-6425
(715) 373-5655
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2402-026
WI
Other
Enumeration date
05/12/2008
Last updated
09/11/2015
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