Healthcare Provider Details

I. General information

NPI: 1720916745
Provider Name (Legal Business Name): JORDYN BUZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 MICHIGAN RD
BAY CITY MI
48706-9310
US

IV. Provider business mailing address

4015 BAY CITY RD
MIDLAND MI
48642-6001
US

V. Phone/Fax

Practice location:
  • Phone: 989-450-3498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: