Provider Demographics
NPI:1083187470
Name:BUECHE, ALYCIA
Entity Type:Individual
Prefix:MRS
First Name:ALYCIA
Middle Name:
Last Name:BUECHE
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 1:8738 QUARTERS LAKE RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2194
Mailing Address - Country:US
Mailing Address - Phone:225-276-6982
Mailing Address - Fax:
Practice Address - Street 1:8738 QUARTERS LAKE RD BLDG 5
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2194
Practice Address - Country:US
Practice Address - Phone:225-276-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7412101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional