Provider Demographics
NPI:1235467515
Name:MUNSCHAUER, CAROL ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:MUNSCHAUER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:605 LEBRUN RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4232
Mailing Address - Country:US
Mailing Address - Phone:716-835-8288
Mailing Address - Fax:
Practice Address - Street 1:605 LEBRUN RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4232
Practice Address - Country:US
Practice Address - Phone:716-835-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8015103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000500424001OtherBLUE CROSS BLUE SHIELD