Provider Demographics
NPI:1629322441
Name:QAMAR-BUSLER, LETICIA M (NMD)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:M
Last Name:QAMAR-BUSLER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5073
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85211-5073
Mailing Address - Country:US
Mailing Address - Phone:225-571-2334
Mailing Address - Fax:480-833-9426
Practice Address - Street 1:40 W BROWN RD
Practice Address - Street 2:SUITE #108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-3400
Practice Address - Country:US
Practice Address - Phone:225-571-2334
Practice Address - Fax:480-833-9426
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1344175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath