Healthcare Provider Details

I. General information

NPI: 1144457318
Provider Name (Legal Business Name): SANDRA DIANE FLURRY BUECHE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5599 HIGHWAY 311
HOUMA LA
70360-2866
US

IV. Provider business mailing address

5599 HIGHWAY 311
HOUMA LA
70360-2866
US

V. Phone/Fax

Practice location:
  • Phone: 985-857-3615
  • Fax: 985-857-3706
Mailing address:
  • Phone: 985-857-3615
  • Fax: 985-857-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLA4521
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: