Basic Information
| Provider Information | |||||||||
| NPI: | 1417056466 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUZA | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSW LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5277 WORCHESTER | ||||||||
| Address2: | |||||||||
| City: | SWARTZ CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484731159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8104448564 | ||||||||
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| Practice Location | |||||||||
| Address1: | 929 STEVENS ST | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485021620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102326081 | ||||||||
| FaxNumber: | 8102326510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 10/02/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801020837 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.