Provider Demographics
NPI:1386479723
Name:BUXMAN, GABRIELLE GOLDIN (PLPC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:GOLDIN
Last Name:BUXMAN
Suffix:
Gender:
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4913 WHISPER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4836
Mailing Address - Country:US
Mailing Address - Phone:941-518-4363
Mailing Address - Fax:
Practice Address - Street 1:601 W NIFONG BLVD STE 1D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-6804
Practice Address - Country:US
Practice Address - Phone:573-228-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024034635101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor