Individual
NATHALY ANDREA BUSTOS ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2921 STRANDEN RD, BALTIMORE, MD 21230-2941
(617) 803-1485
Mailing address
19169 ROMAN WAY, MONTGOMERY VILLAGE, MD 20886-5064
(617) 803-1485
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/09/2020
Last updated
07/13/2022
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