Individual
KATHY BUSTOS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSW LMHP
Contact information
Practice address
2211 PEOPLES RD, SUITE A ROOM 6, BELLEVUE, NE 68005-4670
(402) 978-5174
(402) 341-3616
Mailing address
2211 PEOPLES RD, SUITE A ROOM 6, BELLEVUE, NE 68005-4670
(402) 978-5174
(402) 341-3616
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0970566
—
IA
Enumeration date
01/18/2006
Last updated
07/08/2007
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