Healthcare Provider Details

I. General information

NPI: 1407638752
Provider Name (Legal Business Name): STEPHANIE MICHELLE BUHLER RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 SE RIVERSIDE DR
STUART FL
34994-2584
US

IV. Provider business mailing address

1655 5TH PL
VERO BEACH FL
32962-2103
US

V. Phone/Fax

Practice location:
  • Phone: 772-207-0716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH22032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: