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1710952940
LISA LEANNE GUSTAFSON
FORT SAM HOUSTON, TX
NPI
1710952940
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: TX 32230)
Enumeration Date
2006-02-21
Last Update Date
2007-07-08
Business Address
Ms. LISA LEANNE GUSTAFSON LMSW
3851 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4501
Phone number: 210-916-2460
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Mailing Address
Ms. LISA LEANNE GUSTAFSON LMSW
3851 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4501
Phone number: 210-375-6123
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