Provider Demographics
NPI:1457051971
Name:BUCHEN, SUSAN KAY (SLP, CCC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KAY
Last Name:BUCHEN
Suffix:
Gender:F
Credentials:SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 S 8TH RD
Mailing Address - Street 2:
Mailing Address - City:HUMANSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65674-8636
Mailing Address - Country:US
Mailing Address - Phone:469-371-0090
Mailing Address - Fax:
Practice Address - Street 1:1510 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-1246
Practice Address - Country:US
Practice Address - Phone:417-326-6284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017025952235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist