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Individual

ANDRES BUSTAMANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
370 N KING ST, NORTHAMPTON, MA 01060-1121
(413) 320-4118
(888) 289-5206
Mailing address
370 N KING ST, NORTHAMPTON, MA 01060-1121
(413) 320-4118
(888) 289-5206

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
8148
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1301071
MA
Enumeration date
04/14/2006
Last updated
10/26/2020
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