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1427171099
JILL GUSTAFSON
DIAMOND SPRINGS, CA
NPI
1427171099
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS15684)
Enumeration Date
2007-04-09
Last Update Date
2007-07-08
Business Address
Ms. JILL GUSTAFSON LCSW
493 MAIN ST
DIAMOND SPRINGS, CA 95619-9173
Phone number: 530-644-8013
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Mailing Address
Ms. JILL GUSTAFSON LCSW
493 MAIN ST
DIAMOND SPRINGS, CA 95619-9173
Phone number:
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