Provider Demographics
NPI:1689103913
Name:BUTZ, WILLIAM BURNETTE
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BURNETTE
Last Name:BUTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BELL
Other - Middle Name:
Other - Last Name:BUTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:714 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945
Mailing Address - Country:US
Mailing Address - Phone:530-477-9800
Mailing Address - Fax:530-477-9800
Practice Address - Street 1:714 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945
Practice Address - Country:US
Practice Address - Phone:530-477-9800
Practice Address - Fax:530-477-9800
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor