Provider Demographics
NPI:1942771498
Name:MUECKE, EMILY BUSKIRK (MSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:BUSKIRK
Last Name:MUECKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16912 HAWKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5809
Mailing Address - Country:US
Mailing Address - Phone:813-230-3078
Mailing Address - Fax:
Practice Address - Street 1:1210 MILLENNIUM PKWY STE 1007
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4558
Practice Address - Country:US
Practice Address - Phone:813-296-4159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL126961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical