| NPI | 1396884128 |
|---|---|
| Former Name | CHAUNTEL MARIE GUSTIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 7412) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC003761) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-07-05 |