Provider Demographics
NPI:1164764296
Name:OAKLAND-BUCHANAN, JUDITH (MA)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:OAKLAND-BUCHANAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 PINE STREET
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-3815
Mailing Address - Country:US
Mailing Address - Phone:303-638-8557
Mailing Address - Fax:
Practice Address - Street 1:2727 PINE STREET
Practice Address - Street 2:SUITE 8
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-3815
Practice Address - Country:US
Practice Address - Phone:303-638-8557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1877101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional