Individual
LAURENCE DANIEL BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MCP
Contact information
Practice address
605 W OXFORD AVE, ENID, OK 73701-1208
(580) 233-7220
Mailing address
908 QUAIL CREEK DR, ENID, OK 73703-2809
(580) 233-0943
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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