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Individual
SUSAN G BUCKALLEW
Active
Individual
SUSAN G BUCKALLEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2010032751
MO
101YP2500X
Professional Counselor
Primary
2010032751
MO
Other
Enumeration date
09/21/2010
Last updated
07/28/2026
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