Individual
MS. MARIA BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1418 FILLMORE ST, TWIN FALLS, ID 83301-3380
(208) 735-2237
Mailing address
1418 FILLMORE ST, TWIN FALLS, ID 83301-3380
(208) 735-2237
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013122563
LDS FAMILY SERVICES
ID
Enumeration date
01/13/2014
Last updated
01/13/2014
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