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Individual

RICHARD LOPEZ BUSTOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
1804 W TANSILL ST, CARLSBAD, NM 88220-3796
(408) 966-0942
Mailing address
2402 N RIVERSIDE DR, ESPANOLA, NM 87532-8122
(575) 343-2991

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPCF23032
NM

Other

Enumeration date
07/26/2023
Last updated
07/26/2023
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