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Individual

DANIELA E BUSTAMANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
917 7TH AVE, LONGVIEW, WA 98632-2601
(561) 414-3717
Mailing address
19800 SEDGEFIELD TER, BOCA RATON, FL 33498-4734
(561) 654-3130

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18842
FL

Other

Enumeration date
04/30/2018
Last updated
04/30/2018
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