Provider Demographics
NPI:1245848704
Name:BUELL, JANNA (PSYD)
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:BUELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 MACE RD
Mailing Address - Street 2:
Mailing Address - City:GILBOA
Mailing Address - State:NY
Mailing Address - Zip Code:12076-2600
Mailing Address - Country:US
Mailing Address - Phone:518-301-5512
Mailing Address - Fax:
Practice Address - Street 1:108 MACE RD
Practice Address - Street 2:
Practice Address - City:GILBOA
Practice Address - State:NY
Practice Address - Zip Code:12076-2600
Practice Address - Country:US
Practice Address - Phone:518-301-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool