Individual
ELIZABETH BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
372 WASHINGTON ST, WELLESLEY, MA 02481-6202
(781) 239-3550
(781) 239-3272
Mailing address
372 WASHINGTON ST, WELLESLEY, MA 02481-6202
(781) 239-3550
(781) 239-3272
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
792461
TUFTS HEALTH PLAN
MA
01
—
W05625
BCBSMA
MA
Enumeration date
10/12/2006
Last updated
07/08/2007
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