Gustafson, Debra

Gustafson, Debra is an individual health care provider with primary practice located at 1011 Veterans Memorial Pkwy Bradley Hospital, Riverside RI 02915-5061. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Gustafson, Debra can be contacted via phone (401) 432-1000.

Contact Information

Primary practice address
1011 Veterans Memorial Pkwy Bradley Hospital Riverside RI 02915-5061
Phone: (401) 432-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 9065 Massachusetts
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 9065 Massachusetts

Profile Details

NPI number 1659559037
LBN Legal business name Gustafson, Debra
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2008
Last updated Sep 26th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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