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1720296551
LESLIE DIANNE GUSTAFSON
TUSTIN, CA
NPI
1720296551
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFT31850)
Enumeration Date
2007-05-17
Last Update Date
2007-07-08
Business Address
-- LESLIE DIANNE GUSTAFSON MFT
14751 PLAZA DR STE F
TUSTIN, CA 92780-2773
Phone number: 714-284-7445
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Mailing Address
-- LESLIE DIANNE GUSTAFSON MFT
3 PARMA
IRVINE, CA 92602-1656
Phone number: 714-284-7445
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