MRS. Grace Raissa Gustafson, MS CCC SLP
NPI #1972656122 in Worcester, Massachusetts
Provider Information
- NPI Number
- 1972656122
- Entity Type
- Individual
- Name
- MRS. Grace Raissa Gustafson, MS CCC SLP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- MS CCC SLP
- Enumeration Date
- Jan 19, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- PRENET FAMILY HEALTH SERVICES
- Address 2
- 237 MILLBURY ST
- City
- Worcester
- State
- Massachusetts
- ZIP Code
- 01610
- Phone
- (508) 755-1228
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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