Provider Demographics
NPI:1619523479
Name:BUCHER, EMMA KATHRYN (PSYD)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:KATHRYN
Last Name:BUCHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:KATHRYN
Other - Last Name:TAUFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6615 N. BIG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-2451
Mailing Address - Country:US
Mailing Address - Phone:309-692-6622
Mailing Address - Fax:309-692-6952
Practice Address - Street 1:6615 N. BIG HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-2451
Practice Address - Country:US
Practice Address - Phone:309-692-6622
Practice Address - Fax:309-692-6952
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical