MEDICARE: TARA BUCHY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.2506954	OH

General Provider Information

NPI Number	:	1881322964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA BUCHY

Provider Business Mailing Address
First Line	:	907 W 5TH ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-8306
Country	:	US
Telephone Number	:	937-764-2373
Fax Number	:	937-588-6296

Provider Business Practice Location Address
First Line	:	601 S EDWIN C MOSES BLVD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3424
Country	:	US
Telephone Number	:	100-000-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	06/16/2026

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Directions to “ TARA BUCHY ” Practice Location

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