Individual provider · Type 1 NPI

Lisa Kay Gustafson, MS/LCPC

Professional Counselor · Ottawa, IL

NPI number 1962666875 Active

Practice location

424 W Madison St
Ottawa, IL 61350-2833

Fax (815) 433-3980

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X180.004529 (IL)

Professional Counselor: Definition to come...

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About NPI 1962666875

Lisa Kay Gustafson, MS/LCPC's National Provider Identifier is 1962666875, issued on Jul 10, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Ottawa, IL. The record was last updated on Jul 10, 2008.