Basic Information
Provider Information
NPI: 1679551634
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUEHLER
FirstName: AMY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 750 N FREEDOM BLVD
Address2:  
City: PROVO
State: UT
PostalCode: 846011677
CountryCode: US
TelephoneNumber: 8013734760
FaxNumber: 8013730639
Practice Location
Address1: 750 N FREEDOM BLVD
Address2:  
City: PROVO
State: UT
PostalCode: 846011677
CountryCode: US
TelephoneNumber: 8013734760
FaxNumber: 8013730639
Other Information
ProviderEnumerationDate: 01/09/2006
LastUpdateDate: 05/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X5918883-3502UTN Behavioral Health & Social Service ProvidersSocial Worker 
1041C0700X11244660-3501UTY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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