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General NPI Number Information
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NPI Number | 1689702185
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Entity Type | Individual
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Provider Name | AIMEE J BUSTAMANTE M.ED. , N.C.C., LPC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 2200 VETERANS MEMORIAL BLVD SUITE 105
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City | KENNER
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State | LA
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Zip | 70062-4001
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Country | US
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Telephone | 504-305-4704
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 VETERANS MEMORIAL BLVD SUITE 105
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City | KENNER
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State | LA
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Zip | 70062-4001
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Country | US
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Telephone | 504-305-4704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 79797
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3356
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License Number State | LA
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