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General NPI Number Information
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NPI Number | 1578428587
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Entity Type | Individual
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Provider Name | BO BRIDGETTE G BUENO
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Gender | Female
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 515 SW 24TH ST
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City | SAN ANTONIO
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State | TX
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Zip | 78207-4619
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Country | US
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Telephone | 210-744-4828
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Fax |
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Provider Business Mailing Address
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Address Line | 322 SHADYWOOD LN
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6813
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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