Most Relevant Information
Provider Data
| NPI Number: | 1003309022 |
| Provider Name: | MICHELLE T BUSTOS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/13/2018 |
| Last Updated: | 06/13/2018 |
Provider Practice Location
4001 OFFICE COURT DR STE 706
SANTA FE
NM
875074958
Practice Location Phone/Fax
| Phone: | 5053959611 |
| Fax: |
Provider Mailing Location
21600 OXNARD ST
WOODLAND HILLS
CA
913674976
Provider Mailing Phone/Fax
| Phone: | 8183452345 |
| Fax: |