EILEEN GUSTAFSON LCSW PA
Agencies at Cross Creek Blvd, Tampa, FL

License number
Florida LCSW 6283
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: MS. EILEEN GUSTAFSON LCSW
Title: OWNER/THERAPIST
Phone: (352) 428-8463
Address
Address 2
10335 Cross Creek Blvd SUITE 23, Tampa, FL 33647
PO Box 5797, Brooksville, FL 34611
National Provider ID: 1396933446
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EILEEN GUSTAFSON LCSW PA

Tampa, FL  -  Brooksville, FL

Industry:
Business Services at Non-Commercial Site, Individual/Family Services, Nonclassifiable Establishments
Registration:
Jan 3, 2006
Addresses:
10347 Cross Crk Blvd SUITE B, Tampa, FL 33647 (Physical)
Spring Hill, FL 34611 (Mailing)
10335 Cross Crk Blvd, Tampa, FL 33647
3802 Ehrlich Rd, Tampa, FL 33624
PO Box 5797, Brooksville, FL 34611
State ID:
P06000000970
Business type:
Florida Profit Corporation
Secretary:
Eileen Gustafson (Secretary), 10335 Cross Crk Blvd SUITE 23, Tampa, FL 33647 (Physical)
Agent:
Gustafson, Eileen,10347 Cross Crk Blvd SUITE B, Tampa, FL 33647 (Physical)
EIN:
204102722

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