Provider Demographics
NPI:1780208785
Name:BUFALINI, EMMA LANI (LMBT)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:LANI
Last Name:BUFALINI
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 JULIETTE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6744
Mailing Address - Country:US
Mailing Address - Phone:808-728-1210
Mailing Address - Fax:
Practice Address - Street 1:37 JULIETTE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6744
Practice Address - Country:US
Practice Address - Phone:808-728-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16384225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist