Individual
ANGELIA MARIE BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 W COLLEGE AVE, SPOKANE, WA 99201-2010
(509) 324-1420
Mailing address
1101 W COLLEGE AVE, SPOKANE, WA 99201-2010
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
405300000X
Prevention Professional
NA
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
09/25/2018
Last updated
01/30/2019
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