Healthcare Provider Details

I. General information

NPI: 1669991907
Provider Name (Legal Business Name): LAURA BUEHLER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 ALTON AVE
COLUMBUS OH
43219-3711
US

IV. Provider business mailing address

453 CHATHAM RD
COLUMBUS OH
43214-3319
US

V. Phone/Fax

Practice location:
  • Phone: 614-315-6890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS1600416
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: