Provider Demographics
NPI:1942244207
Name:BUECHE, BRANDON JOSEPH (OT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JOSEPH
Last Name:BUECHE
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23930 CALVIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3104
Mailing Address - Country:US
Mailing Address - Phone:225-687-8914
Mailing Address - Fax:225-687-8915
Practice Address - Street 1:23930 CALVIN ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3104
Practice Address - Country:US
Practice Address - Phone:225-687-8914
Practice Address - Fax:225-687-8915
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11014225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist