Healthcare Provider Details

I. General information

NPI: 1649672130
Provider Name (Legal Business Name): ERROL BUECHE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 WESTMINSTER DR
UPPER ARLINGTON OH
43221-3445
US

IV. Provider business mailing address

1465 WESTMINSTER DR
UPPER ARLINGTON OH
43221-3445
US

V. Phone/Fax

Practice location:
  • Phone: 614-439-3239
  • Fax:
Mailing address:
  • Phone: 614-439-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0005363
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: