Individual
MRS. BETH E BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
1247 LAKES RD, MONROE, NY 10950-4221
(845) 477-2411
Mailing address
PO BOX 8, GREENWOOD LAKE, NY 10925-0008
(845) 477-2411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
014677-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01455325
—
NY
Enumeration date
10/20/2011
Last updated
10/20/2011
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