| NPI | 1821393711 |
|---|---|
| Former Name | JEANNE KAY GUSTAFSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801092771) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2022-07-21 |