Individual
LARISSA BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14609 WESTBROOK DR, URBANDALE, IA 50323-2411
(515) 650-3085
Mailing address
14609 WESTBROOK DR, URBANDALE, IA 50323-2411
(515) 650-3085
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
083876
IA
Other
Enumeration date
10/12/2016
Last updated
05/16/2025
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