Provider Demographics
NPI:1043557754
Name:BUENZLE, DESIREE JOAN
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:JOAN
Last Name:BUENZLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KENSINGTON TER
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-1410
Mailing Address - Country:US
Mailing Address - Phone:914-787-9612
Mailing Address - Fax:
Practice Address - Street 1:2 KENSINGTON TER
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-1410
Practice Address - Country:US
Practice Address - Phone:914-787-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health