Healthcare Provider Details

I. General information

NPI: 1407910870
Provider Name (Legal Business Name): ESTHER W BUCHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7087 MILL VALLEY RD
MECHANICSVILLE VA
23111-5220
US

IV. Provider business mailing address

7087 MILL VALLEY RD
MECHANICSVILLE VA
23111-5220
US

V. Phone/Fax

Practice location:
  • Phone: 804-730-7459
  • Fax: 206-202-4495
Mailing address:
  • Phone: 804-730-7459
  • Fax: 206-202-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number0119000182
License Number StateVA

VIII. Authorized Official

Name: MRS. ESTHER BUCHER
Title or Position: OWNER
Credential: MS OTR L
Phone: 804-730-7459