Jillian Gustafson
Counselor, Mental Health in Rochelle, IL. Individual provider (NPI-1).
NPI number1083164875
StatusActive
Last updated in NPPESOct 5, 2016
Details
- NPI
- 1083164875
- Entity type
- Individual (NPI-1)
- Name
- Jillian Gustafson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2016
- Last updated
- Oct 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
1321 N 7th StRochelle, IL 61068-1185
Phone 815-562-3801
Mailing address
1123 Jenny DrApt F
Sycamore, IL 60178-9556
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