Provider Demographics
NPI:1891767422
Name:BUHL, M.A. JANE (MFT, PHD)
Entity Type:Individual
Prefix:DR
First Name:M.A. JANE
Middle Name:
Last Name:BUHL
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOLLOW ROAD
Mailing Address - Street 2:POB 234
Mailing Address - City:BIRCHRUNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19421-0234
Mailing Address - Country:US
Mailing Address - Phone:610-495-8853
Mailing Address - Fax:
Practice Address - Street 1:412 E KING ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3004
Practice Address - Country:US
Practice Address - Phone:610-495-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007938-L103TA0700X
PAPS 007938-L103TC0700X, 103TF0000X, 103T00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA532680Medicare UPIN
PA670750Medicare ID - Type Unspecified