Provider Demographics
NPI:1356619266
Name:BUCHANAN-EMERY, MELINDA (LMFT)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:BUCHANAN-EMERY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:459 EAST 1000 SOUTH
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062
Mailing Address - Country:US
Mailing Address - Phone:801-216-8000
Mailing Address - Fax:
Practice Address - Street 1:459 EAST 1000 SOUTH
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062
Practice Address - Country:US
Practice Address - Phone:801-326-9557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48227106H00000X
UT7396773-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist