Healthcare Provider Details

I. General information

NPI: 1831371921
Provider Name (Legal Business Name): MARGARET SUZANNE BUZAN LCSW, DCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BUTLER CREEK CT
OVIEDO FL
32765-5617
US

IV. Provider business mailing address

1001 BUTLER CREEK CT
OVIEDO FL
32765-5617
US

V. Phone/Fax

Practice location:
  • Phone: 407-702-4718
  • Fax: 407-366-7153
Mailing address:
  • Phone: 407-702-4718
  • Fax: 407-366-7153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW 3533
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: