Individual
KACI MARIE BUSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MARQUETTE AVE NW, ALBUQUERQUE, NM 87102-5340
(505) 681-6516
Mailing address
419 IRON ST, GRANTS, NM 87020-3628
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
07/15/2026
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