Individual
PATRICIA DIANE BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
6110 SHALLOWFORD RD, CHATTONOOGA, TN 37421
(800) 632-6074
(866) 341-7509
Mailing address
7513 DOVE VALLEY DRIVE, NASHVILLE, TN 37221-2322
(615) 662-8986
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P0000001865
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3686238
—
TN
Enumeration date
09/19/2006
Last updated
02/09/2008
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