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General NPI Number Information
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NPI Number | 1497629281
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Entity Type | Individual
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Provider Name | MICHELLE PAIGE BULACH
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Gender | Female
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 504 HALLMARK DR
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City | EATON
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State | OH
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Zip | 45320-8648
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Country | US
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Telephone | 937-456-2805
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Fax |
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Provider Business Mailing Address
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Address Line | 2154 BARNETTS MILL RD
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City | CAMDEN
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State | OH
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Zip | 45311-8832
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Country | US
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Telephone | 513-283-4313
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2512986
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License Number State | OH
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