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1902198872
RICHARD L. GUSTAFSON
ANCHORAGE, AK
NPI
1902198872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: AK 527)
Enumeration Date
2011-05-10
Last Update Date
2013-07-22
Business Address
-- RICHARD L. GUSTAFSON LPC
4320 DIPLOMACY DR SUITE 1500
ANCHORAGE, AK 99508-5925
Phone number: 907-729-2500
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Mailing Address
-- RICHARD L. GUSTAFSON LPC
4501 DIPLOMACY DR ATTN: PROVIDER ENROLLMENT SERVICES
ANCHORAGE, AK 99508-5919
Phone number: 907-729-8624
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