Doctor Name: | TYLER BUCHHOLZ |
NPI Number: | 1972905123 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | SP22252 |
Business Practice Address: | 5762 Bolsa Ave Suite 101 Huntington Beach, CA - 926491172 |
Business Phone Number: | 7142922322 |
Business Fax Number: | 7148664153 |
Mailing Address: | 5762 Bolsa Ave, Suite 101 HUNTINGTON BEACH |
State: | CA |
Postal Code: | 926491172 |
Phone Number: | 7142922322 |
Fax Number: | 7148664153 |
NPI Enumeration Date: | 09/18/2014 |
NPI Last Update Date: | 10/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP22252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |