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General NPI Number Information
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NPI Number | 1134316466
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Entity Type | Individual
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Provider Name | DEBORAH A BULEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 15 S MAIN ST
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City | SPRINGBORO
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State | OH
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Zip | 45066-2310
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Country | US
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Telephone | 937-748-0406
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 HERITAGE LAKE DR
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City | CENTERVILLE
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State | OH
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Zip | 45458-6067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5871
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License Number State | OH
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