Individual
MRS. DONNA G BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
4407 N 55TH AVE, PHOENIX, AZ 85031-1802
(623) 691-2341
(623) 691-4320
Mailing address
9644 W CLARA LN, PEORIA, AZ 85382-5130
(623) 322-6014
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1577
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP1577
AZ DEPART OF HEALTH SERVI
AZ
Enumeration date
02/20/2007
Last updated
07/08/2007
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