Individual
ELIZABETH BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2535 KETTNER BLVD STE 1A4, SAN DIEGO, CA 92101-1252
(619) 615-0701
Mailing address
2535 KETTNER BLVD STE 1A4, SAN DIEGO, CA 92101-1252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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