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JORDAN BUCKLEY MA
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1336813773
Individual Registrant: JORDAN BUCKLEY MA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1501 S PINELLAS AVE STE P TARPON SPRINGS, FL 34689-1952 US
Tel: 562-544-9564 Fax: --
Tel: 562-544-9564 Fax: --
Contact information for business:
1004 N FLORIDA AVE TARPON SPRINGS, FL 34689-2113 US
Tel: 562-544-9564 Fax: --
Tel: 562-544-9564 Fax: --
Registration Information:
NPI: 1336813773
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | FL | IMH20108 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
