Provider Demographics
NPI:1518735141
Name:BUCZEK, THERESA JOY
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:JOY
Last Name:BUCZEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PERRY HWY STE 118
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2164
Mailing Address - Country:US
Mailing Address - Phone:412-212-6441
Mailing Address - Fax:
Practice Address - Street 1:1130 PERRY HWY STE 118
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2164
Practice Address - Country:US
Practice Address - Phone:412-212-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health