Individual
NICOLE BUSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
960 4TH ST NW, WAUKON, IA 52172-1059
(563) 568-3493
Mailing address
1439 295TH AVE, FORT ATKINSON, IA 52144-7448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
078442
IA
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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