Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRODERICK DANIEL BLUES BUCKHOLZ, BA
Active Sole ProprietorMR. BRODERICK DANIEL BLUES BUCKHOLZ, BA is a Mental Health Counselor healthcare provider located in JASPER, Oregon. NPI 1427756030 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · JASPER, OR
Registration Details
- NPI Number
- 1427756030
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 22, 2023 (3.2924400841009 yrs)
- Last Updated
- Feb 22, 2023
- Sole Proprietor
- Yes
Practice Information
- Address
-
37875 JASPER LOWELL RDJASPER, OR, 974389751Browse OR providers · Browse ZIP 97438
- Phone
- 5417471235
- Fax
- 5417474722
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Other Mental Health Counselor Providers in JASPER, OR
| Name | Credential | NPI |
|---|---|---|
| HYLA M DOBAJ | MS MA | 1225151707 |
| MR. ANDREW TYLER | B.A.; QMHP | 1841480845 |
| MRS. EDEN HUSTON | M.S. | 1043400096 |
| MRS. JORDAN BANDAOGO | B.A.; QMHA | 1841480837 |
| MR. ADAM ZANOTTO | BA PSYCH; QMHA | 1285824268 |
| MRS. JULIE ENGEL | B.A., QMHA | 1003006859 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.