Individual
MRS. JENNIFER ANN BUCKLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S
Contact information
Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766049900
—
FL
Enumeration date
01/08/2007
Last updated
10/07/2008
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