Bucchianeri, Michaela Marie
Bucchianeri, Michaela Marie is an individual health care provider with primary practice located at 12301 Whitewater Dr Ste 101 , Minnetonka MN 55343-4157. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bucchianeri, Michaela Marie can be contacted via phone (952) 999-6097.Contact Information
Primary practice address
12301 Whitewater Dr Ste 101
Minnetonka MN 55343-4157
Phone: (952) 999-6097
Fax: (952) 426-0508
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | LP6153 | Minnesota |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP6153 | Minnesota |
Profile Details
| NPI number | 1255840187 |
|---|---|
| LBN Legal business name | Bucchianeri, Michaela Marie |
| Credentials | PH.D, LP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2017 |
| Last updated | Nov 20th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255840187 | NPPES |
| Minnesota | MEDICAID | 1255840187 |
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