Organization
TRANSFORMATIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LEIGH BUSTAMANTE PHD (PSYCHOLOGIST)
(801) 618-0852
Entity
Organization
Contact information
Practice address
4055 S 700 E STE 102F, SALT LAKE CITY, UT 84107-2174
(801) 618-0852
Mailing address
1187 E CHARLTON AVE, SALT LAKE CITY, UT 84106-2603
(928) 607-4677
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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