Healthcare Provider Details

I. General information

NPI: 1164764296
Provider Name (Legal Business Name): JUDITH OAKLAND-BUCHANAN M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 PINE STREET SUITE 8
BOULDER CO
80302-3815
US

IV. Provider business mailing address

2727 PINE STREET SUITE 8
BOULDER CO
80302-3815
US

V. Phone/Fax

Practice location:
  • Phone: 303-638-8557
  • Fax:
Mailing address:
  • Phone: 303-638-8557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1877
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: