Individual
DR. SUSAN PHILLIPS BUCKELEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-4000
Mailing address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-4000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2347
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3156394
BCBS
TN
05
—
3981661
—
TN
Enumeration date
08/21/2006
Last updated
02/03/2023
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