Organization
CAPE COD PSYCHOLOGICAL TESTING, INC.
Active
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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