Melissa Gustafson, LSW
Social Worker in Chicago, IL. Individual provider (NPI-1).
NPI number1124574652
StatusActive
Last updated in NPPESAug 25, 2016
Details
- NPI
- 1124574652
- Entity type
- Individual (NPI-1)
- Name
- Melissa Gustafson
- Credential
- LSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2016
- Last updated
- Aug 25, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 1932318920 | IL | Yes |
Practice location
5517 N Kenmore AveChicago, IL 60640-1515
Phone 773-275-7962
Mailing address
5517 N Kenmore AveChicago, IL 60640-1515
Phone 773-275-7962
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