Provider Demographics
NPI:1275677445
Name:BURCKBUCHLER, KATHRYN GRUNFELDER (MA IN COUNSELING)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GRUNFELDER
Last Name:BURCKBUCHLER
Suffix:
Gender:F
Credentials:MA IN COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 159TH CT N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-6866
Mailing Address - Country:US
Mailing Address - Phone:561-352-7022
Mailing Address - Fax:
Practice Address - Street 1:600 SANDTREE DR STE 205
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33403-1538
Practice Address - Country:US
Practice Address - Phone:561-352-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8359101YM0800X
WI1076-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional