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1689717472
CHARLES LEONARD GUSTAFSON
COVINA, CA
NPI
1689717472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 5983)
Enumeration Date
2007-02-14
Last Update Date
2007-07-08
Business Address
Mr. CHARLES LEONARD GUSTAFSON MFT
599 S BARRANCA ST #224
COVINA, CA 91723
Phone number: 626-966-2662
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Mailing Address
Mr. CHARLES LEONARD GUSTAFSON MFT
599 S BARRANCA ST #224
COVINA, CA 91723
Phone number: 626-966-2662
Copy
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