Individual provider · Type 1 NPI

Tracy Elaine Gustafson, MA

Mental Health Counselor · Pawtucket, RI

NPI number 1093230369 Active

Practice location

160 Beechwood Ave
Pawtucket, RI 02860-5402

Fax (401) 724-8488

Mailing address

249 Roosevelt Ave
Pawtucket, RI 02860-2134

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1093230369

Tracy Elaine Gustafson, MA's National Provider Identifier is 1093230369, issued on Aug 8, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Pawtucket, RI. The record was last updated on Aug 8, 2017.