Individual
EARLENE BUSTILLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2514 82ND ST, SUITE G, LUBBOCK, TX 79423-2222
(806) 745-7995
(806) 745-7350
Mailing address
2514 82ND ST, SUITE G, LUBBOCK, TX 79423-2222
(806) 745-7995
(806) 745-7350
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
23845
TX
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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