Individual
MICHAEL BUSTAMANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LCMHC
Contact information
Practice address
1138 PINE ST, BURLINGTON, VT 05401-5353
(802) 488-6600
(802) 488-6901
Mailing address
441 B MAPLE STREET, BURLINGTON, VT 05401
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000707
VT
Other
Enumeration date
11/15/2006
Last updated
08/06/2007
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