Doctor Name: | MS. ERIN GUSTAFSON |
NPI Number: | 1710395587 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3982154 |
Business Practice Address: | 261 French St Peshtigo, WI - 541571217 |
Business Phone Number: | 7155822200 |
Business Fax Number: | 7155822222 |
Mailing Address: | 1970 Navajo St, RHINELANDER |
State: | WI |
Postal Code: | 545018890 |
Phone Number: | 7154201593 |
Fax Number: | 7153620512 |
NPI Enumeration Date: | 07/24/2014 |
NPI Last Update Date: | 07/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3982154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |