MEDICARE: DR. MONICA PAIGE BUETTEL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	3531	CO

General Provider Information

NPI Number	:	1811290570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA PAIGE BUETTEL PH.D.

Provider Business Mailing Address
First Line	:	29511 3RD ST
Second Line	:	PO BOX 741
City	:	SNYDER
State	:	CO
Zip	:	80750-8005
Country	:	US
Telephone Number	:	970-396-9523
Fax Number	:	970-367-1924

Provider Business Practice Location Address
First Line	:	324 E RAILROAD AVE
Second Line	:	SUITE #500
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3145
Country	:	US
Telephone Number	:	970-396-9523
Fax Number	:	970-367-1924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	02/17/2016

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