Individual
EDMUND TAYLOE BUCKMAN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCASA, LPCA
Contact information
Practice address
614 CAPITAL BLVD APT 213, RALEIGH, NC 27603-1157
(252) 943-1536
Mailing address
614 CAPITAL BLVD APT 213, RALEIGH, NC 27603-1157
(252) 943-1536
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
25328
NC
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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