Shantelle Noel Buethe, M.A.

Individual provider Active NPI Marriage & Family Therapist · Turlock, CA

NPI 1770780595 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1770780595
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
IMF#52721 (CA)
Practice address
743 Alpha Rd
Turlock, CA 95380-5505
Phone
(209) 668-4651
Fax
(209) 668-4666
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMF#52721CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF#52721 CA Yes

Addresses

Primary practice location

743 Alpha Rd
Turlock, CA 95380-5505

Mailing address

743 Alpha Rd
Turlock, CA 95380-5505
Phone (209) 668-4651

Other providers in Turlock, CA

All providers in Turlock, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.