Organization
LILA BUCKLIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILA BUCKLIN LICSW (PSYCHOTHERAIST)
(617) 642-8929
Entity
Organization
Contact information
Practice address
65 CORNWALL ST UNIT 104, JAMAICA PLAIN, MA 02130-2696
(617) 642-8929
Mailing address
65 CORNWALL ST UNIT 104, JAMAICA PLAIN, MA 02130-2696
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
118583
MA
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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