Individual
AUDREY LEE BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LAMKIN ST APT 101, PUEBLO, CO 81003-3558
(719) 543-6633
Mailing address
2805 PINE ST, PUEBLO, CO 81004-4036
(719) 415-1970
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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