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General NPI Number Information
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NPI Number | 1912317959
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Entity Type | Individual
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Provider Name | TAMARA BUCHENBERGER
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Gender | Female
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 2201 TUCKER STATION RD
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City | LOUISVILLE
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State | KY
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Zip | 40299-4524
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Country | US
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Telephone | 502-366-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 3314 STRATFORD AVE
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City | LOUISVILLE
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State | KY
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Zip | 40218-1011
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Country | US
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Telephone | 502-592-3029
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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