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1093230369
TRACY ELAINE GUSTAFSON
PAWTUCKET, RI
NPI
1093230369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-08-08
Last Update Date
2017-08-08
Business Address
TRACY ELAINE GUSTAFSON MA
160 BEECHWOOD AVE
PAWTUCKET, RI 02860-5402
Phone number: 401-724-8400
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Mailing Address
TRACY ELAINE GUSTAFSON MA
249 ROOSEVELT AVE
PAWTUCKET, RI 02860-2134
Phone number: 401-724-8400
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