Individual
COLLEEN BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 S 107TH AVE, AVONDALE, AZ 85323-2209
(313) 505-3665
Mailing address
3800 N EL MIRAGE DR, APT 5825, AVONDALE, AZ 85392-3843
(313) 505-3665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP9005
AZ
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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