Individual provider · NPI-1

Laura Elena Fernandez Bustamante, MA, BCBA

Behavior Analyst · Piscataway, NJ

NPI number1477415511
StatusActive
Last updated in NPPESNov 26, 2025

Details

NPI
1477415511
Entity type
Individual (NPI-1)
Name
Laura Elena Fernandez Bustamante
Credential
MA, BCBA
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 26, 2025
Certification date
Nov 26, 2025
Last updated
Nov 26, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst––Yes

Practice location

200 Centennial Ave
Piscataway, NJ 08854-3950

Phone 732-426-5470

Mailing address

710 Green Hill Manor Dr
Franklin Park, NJ 08823-2619

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