Individual
SHARETTA BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1090 W SOUTH BOUNDARY ST, STE 600, PERRYSBURG, OH 43551-5234
(419) 873-8280
Mailing address
1090 W SOUTH BOUNDARY ST, STE 600, PERRYSBURG, OH 43551-5234
(419) 873-8280
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.160672
OH
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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