Individual
ERIN MARIE GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6501 S PROMONTORY DR, CHICAGO, IL 60649-1003
(773) 256-5778
Mailing address
6501 S PROMONTORY DR, CHICAGO, IL 60649-1003
(773) 256-5778
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149.017736
IL
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/02/2011
Last updated
09/15/2021
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