Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1381 | TN |
N | 103T00000X | Psychologist | 1381 | TN |
Y | 102L00000X | Psychologist | 30447 | MS |
Y | 103T00000X | Psychologist | 30447 | MS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1381 | TN |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 30447 | MS |
NPI | 1184763229 |
---|---|
Provider Name | Dr. James W Buechele |
First Address | Hernando, MS 38632-1609 |
Second Address | Hernando, MS 38632-1609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 06/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00119063 | (05) | MS |