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1821058066
STEPHANIE R GUSTAVE
HERRIN, IL
NPI
1821058066
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 178002940)
Enumeration Date
2006-03-23
Last Update Date
2007-07-08
Business Address
-- STEPHANIE R GUSTAVE LPC, AMFT
109 LOU ANN DR
HERRIN, IL 62948-3733
Phone number: 618-988-1330
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Mailing Address
-- STEPHANIE R GUSTAVE LPC, AMFT
573 BRUSH HILL RD
CARBONDALE, IL 62901-5731
Phone number: 618-529-4599
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