Individual
MRS. AMY TILSON BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11 CHILDREN'S WAY SLOT # 654, SOUTH CAMPUS BLDG 5TH FLOOR, LITTLE ROCK, AR 72202-4610
(501) 364-1993
Mailing address
218 BEECHWOOD ST, LITTLE ROCK, AR 72205-3814
(501) 993-5511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2189-M
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172504795
—
AR
Enumeration date
04/30/2008
Last updated
02/08/2011
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