Provider Demographics
NPI:1689139511
Name:BUCHMANN, CRYSTAL A (MS)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:A
Last Name:BUCHMANN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1711
Mailing Address - Country:US
Mailing Address - Phone:207-615-2030
Mailing Address - Fax:
Practice Address - Street 1:611 BROAD AVE
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1510
Practice Address - Country:US
Practice Address - Phone:724-405-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional