Individual
JEANETTE BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2150 S COUNTRY CLUB DR STE 20, MESA, AZ 85210-6879
(480) 398-4281
(480) 398-4281
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
AZ
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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