Michelle Lee Gustafson, MSW, LICSW

NPI #1700823952 in Mpls, Minnesota

Provider Information

NPI Number
1700823952
Entity Type
Individual
Name
Michelle Lee Gustafson, MSW, LICSW
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Credential
MSW, LICSW
Enumeration Date
May 31, 2006
Last Updated
Jan 6, 2023

Practice Location

Address
FAIRVIEW UNIVERSITY HOSPITAL
Address 2
2450 RIVERSIDE AVENUE SOUTH
City
Mpls
ZIP Code
55454
Phone
(612) 273-5640

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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