Healthcare Provider Details

I. General information

NPI: 1275869505
Provider Name (Legal Business Name): JENNIFER L BUECHLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 BOILING SPRINGS RD SUITE 2800
SPARTANBURG SC
29303-4201
US

IV. Provider business mailing address

1330 BOILING SPRINGS RD SUITE 2800
SPARTANBURG SC
29303-4201
US

V. Phone/Fax

Practice location:
  • Phone: 864-573-6908
  • Fax: 864-585-8808
Mailing address:
  • Phone: 864-573-6908
  • Fax: 864-585-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1131
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: