Individual
AILAINA BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 SMITHVILLE CHURCH RD STE 1100, WARNER ROBINS, GA 31088-9097
(800) 832-9419
(855) 859-1671
Mailing address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
(855) 859-1671
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-264738
GA
Other
Enumeration date
04/12/2023
Last updated
01/16/2024
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