Healthcare Provider Details

I. General information

NPI: 1720272636
Provider Name (Legal Business Name): CELIA B. BUECHE MSP, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6086 BRUSH ARBOR CT
GREENSBORO NC
27455-8327
US

IV. Provider business mailing address

6086 BRUSH ARBOR COURT
GREENSBORO NC
27455
US

V. Phone/Fax

Practice location:
  • Phone: 704-287-7442
  • Fax:
Mailing address:
  • Phone: 704-287-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3452
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: