MS. Lisa Kay Gustafson, MS/LCPC

NPI #1962666875 in Ottawa, Illinois

Provider Information

NPI Number: 1962666875
Entity Type: Individual
Name: MS. Lisa Kay Gustafson, MS/LCPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: MS/LCPC
Enumeration Date: Jul 10, 2008
Last Updated: Jul 10, 2008

Practice Location

Address: 424 W MADISON ST
City: Ottawa
State: Illinois
ZIP Code: 61350-2833
Phone: (815) 431-3022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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