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1407280456
TANYA L GUSTAFSON
KENNESAW, GA
NPI
1407280456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: GA MFT001356)
Enumeration Date
2013-08-27
Last Update Date
2014-09-22
Business Address
Ms. TANYA L GUSTAFSON LAMFT
1815 OLD 41 HWY NW SUITE 110
KENNESAW, GA 30152-4420
Phone number: 678-468-9103
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Mailing Address
Ms. TANYA L GUSTAFSON LAMFT
1815 OLD 41 HWY NW SUITE 110
KENNESAW, GA 30152-4420
Phone number: 678-468-9103
Copy
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