Organization
CAPE COD PSYCHOLOGICAL TESTING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL FREEMAN GUSTAFSON PSY.D. (LICENCED CLINICAL PSYCHOLOGIST)
(508) 362-1180
Entity
Organization
Contact information
Practice address
1074 MAIN ST, WEST BARNSTABLE, MA 02668-1142
(508) 362-1180
(508) 362-7048
Mailing address
1074 MAIN ST, WEST BARNSTABLE, MA 02668-1142
(508) 362-1180
(508) 362-7048
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MA8060
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110096626A
—
MA
Enumeration date
08/12/2010
Last updated
09/06/2013
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