Lisa Leanne Gustafson LMSW

NPI 1710952940 - Social Worker - 104100000X

NPI Details
NPI 1710952940
Gender Female
Enumeration Date 02/21/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
3851 ROGER BROOKE DR
FORT SAM HOUSTON TX, 78234-4501, US
Phone (210) 916-2460
Fax
Business Location
3851 ROGER BROOKE DR
FORT SAM HOUSTON TX, 78234-4501, US
Phone (210) 375-6123
Fax
Toxanomy
Taxonomy Code 104100000X
License State Texas
License Number 32230
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According to our database, Ms. Lisa Leanne Gustafson LMSW NPI is 1710952940, taxonomy code is 104100000X and license number is 32230, license state is located at Texas. Lisa Leanne Gustafson LMSW physically located at 3851 Roger Brooke Dr, Fort Sam Houston TX, 78234-4501. NPI Number Lisa Leanne Gustafson LMSW has the Individual type.

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1710952940 NPI number is provided on an as is basis without warranty of any kind. 1710952940 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Leanne Gustafson LMSW are for informational purposes only.