GRACE RAISSA GUSTAFSON

WORCESTER, MA
NPI1972656122
Former NameGRACE RAISSA BRILLIANT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: MA  5053)
Enumeration Date2007-01-19
Last Update Date2007-07-08
Business Address
Mrs. GRACE RAISSA GUSTAFSON MS CCC SLP
PRENET FAMILY HEALTH SERVICES 237 MILLBURY ST
WORCESTER, MA 01610
Phone number: 508-755-1228
Mailing Address
Mrs. GRACE RAISSA GUSTAFSON MS CCC SLP
359 WEST THOMPSON RD
THOMPSON, CT 06277
Phone number: 860-963-0267