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1972892792
DIANE GUSTAW
LAS VEGAS, NV
NPI
1972892792
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2011-04-01
Last Update Date
2011-04-01
Business Address
Ms. DIANE GUSTAW QMHA
8777 W MAULE AVENUE 2074
LAS VEGAS, NV 89148-4894
Phone number: 631-839-2462
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Mailing Address
Ms. DIANE GUSTAW QMHA
8777 W MAULE AVE 2074
LAS VEGAS, NV 89148-4868
Phone number: 631-839-2462
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