Individual
DESIREE NICOLE BUSTAMANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCH INTERN
Contact information
Practice address
310 W ELM ST, DEMING, NM 88030-4123
(575) 546-0427
Mailing address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
(575) 546-5994
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
393374
NM
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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