Individual
DR. CARL SCOTT FREEMAN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1074 MAIN ST, WEST BARNSTABLE, MA 02668-1142
(508) 362-1180
(508) 362-7048
Mailing address
104 BRIGANTINE DR, HATCHVILLE, MA 02536-3958
(508) 563-5037
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8060
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0502944
—
MA
Enumeration date
11/03/2006
Last updated
07/09/2007
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