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1174682009
JACKIE LYNN BUSTAMANTE
LONG BEACH, CA
NPI
1174682009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 30317)
Enumeration Date
2006-12-06
Last Update Date
2011-04-20
Business Address
Ms. JACKIE LYNN BUSTAMANTE
1716 CLARK AVE STE 109
LONG BEACH, CA 90815-3801
Phone number: 562-706-1072
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Mailing Address
Ms. JACKIE LYNN BUSTAMANTE
1716 CLARK AVE # 109
LONG BEACH, CA 90815-3801
Phone number: 562-706-1072
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