Provider Demographics
NPI:1164522926
Name:BUCHBAUER, MICHELE W (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:W
Last Name:BUCHBAUER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SPARTA AVE.
Mailing Address - Street 2:BLDG. C, SUITE 8
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:973-729-0272
Mailing Address - Fax:973-786-0125
Practice Address - Street 1:350 SPARTA AVE.
Practice Address - Street 2:SUITE C-8
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1150
Practice Address - Country:US
Practice Address - Phone:973-729-0272
Practice Address - Fax:973-786-0125
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2420103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist