Individual
KOURTNEY BUCKALLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 JAMISON ST, KIRKSVILLE, MO 63501-3943
(660) 665-1962
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
09/18/2024
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