Provider Demographics
NPI:1275981664
Name:BLAUCH, DANA BUSKIRK (MA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:BUSKIRK
Last Name:BLAUCH
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 1:8297 HARPINE HWY
Mailing Address - Street 2:
Mailing Address - City:LINVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22834-2214
Mailing Address - Country:US
Mailing Address - Phone:540-810-3888
Mailing Address - Fax:
Practice Address - Street 1:8297 HARPINE HWY
Practice Address - Street 2:
Practice Address - City:LINVILLE
Practice Address - State:VA
Practice Address - Zip Code:22834-2214
Practice Address - Country:US
Practice Address - Phone:540-810-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional