Individual
MARIA BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
1051 HASKELL ST., SUITE 200, FORT WORTH, TX 76107
(817) 377-4011
(817) 377-9269
Mailing address
1051 HASKELL ST., SUITE 200, FORT WORTH, TX 76107
(817) 377-4011
(817) 377-9269
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
20442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20442
LICENSE NUMBER
TX
Enumeration date
05/01/2007
Last updated
10/20/2009
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