Individual provider · NPI-1

Aimee Bustos

Speech-Language Pathologist, · Queen Creek, AZ

NPI number1124488960
StatusActive
Last updated in NPPESSep 16, 2019

Details

NPI
1124488960
Entity type
Individual (NPI-1)
Name
Aimee Bustos
Sex
Female
Sole proprietor
No
Enumeration date
Mar 6, 2016
Last updated
Sep 16, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SLP11895AZYes
2355S0801X Specialist/Technologist, Speech-Language Assistant5915NM

Practice location

1302 W Plane Tree Ave
Queen Creek, AZ 85140-7679

Phone 505-573-9211

Mailing address

1302 W Plane Tree Ave
Queen Creek, AZ 85140-7679

Phone 505-573-9211

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