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NPI Profile for LESLEY W GUSTAFSON in SOUTHBOROUGH, MA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X |
| NPI # | 1093489692 |
|
| Status | Active | |
| Credentials | LMHC (Licensed Mental Health Counselor) | |
| Entity | Individual | |
| Enumeration date | 08/06/2021 | |
| Last updated | 08/06/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LESLEY W GUSTAFSON
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LESLEY W GUSTAFSON, LMHC