Individual
KATELYN RENEE BUSTILLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
355 W WESTCHESTER PKWY, GRAND PRAIRIE, TX 75052-5284
(972) 263-3663
Mailing address
2926 W ROYAL LN APT 3102, IRVING, TX 75063-5746
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215482
TX
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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