Individual
JESSICA JEAN BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1407 SAINT ANDREW ST, STE 100, LA CROSSE, WI 54603-3301
(608) 789-4837
Mailing address
215 S LINCOLN ST, SHAWANO, WI 54166-2421
(608) 304-3553
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
10976.120
WI
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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