Basic Information
Provider Information
NPI: 1346637881
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUERGER
FirstName: NATALIE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 127S 500 E 600
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841021971
CountryCode: US
TelephoneNumber: 8015876336
FaxNumber: 8017158228
Practice Location
Address1: 295 S CHIPETA WAY
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841081287
CountryCode: US
TelephoneNumber: 8015877400
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/22/2015
LastUpdateDate: 11/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC2200X9237741-2501UTY Behavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent

No ID Information.


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