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General NPI Number Information
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NPI Number | 1245031160
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Entity Type | Individual
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Provider Name | MICHELLE JEAN BUELL
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 769 W BLAINE ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-3970
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Country | US
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Telephone | 951-358-4705
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Fax |
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Provider Business Mailing Address
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Address Line | 29294 RIPTIDE DR
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City | MENIFEE
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State | CA
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Zip | 92585-3340
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW126098
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License Number State | CA
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