Individual
MELISSA BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 284-6611
Mailing address
311 W PARK ST, MORRISON, IL 61270-2319
(815) 213-4389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
149.024911
IL
104100000X
Social Worker
Primary
149.024911
IL
Other
Enumeration date
08/21/2013
Last updated
06/05/2023
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