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JORDAN BUCKLEY MA

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1336813773

Individual Registrant:
 JORDAN  BUCKLEY MA
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: --

Contact information for business:
1004 N FLORIDA AVE  TARPON SPRINGS, FL 34689-2113 US
Tel: 562-544-9564  Fax: --

Registration Information:
NPI: 1336813773
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
FLIMH20108

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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