| Doctor Name: | ANTHONY BUSTOS |
| NPI Number: | 1124351192 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CONTRACTS/CORRECTION |
| License Number: | |
| Business Practice Address: | 121 Townsgate Clovis, NM - 88101 |
| Business Phone Number: | 5757422620 |
| Business Fax Number: | 5757423182 |
| Mailing Address: | Po Box 28220, SANTA FE |
| State: | NM |
| Postal Code: | 87592 |
| Phone Number: | 5054715006 |
| Fax Number: | 5058209220 |
| NPI Enumeration Date: | 09/09/2009 |
| NPI Last Update Date: | 09/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |