Individual
DR. JOHNNY JASON BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
14256 S 47TH ST, PHOENIX, AZ 85044-6205
(480) 510-8502
Mailing address
14256 S 47TH ST, PHOENIX, AZ 85044-6205
(480) 510-8502
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-13746
AZ
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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