Individual
KELLY ANN BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, SLP
Contact information
Practice address
742 STERBENZ DR, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Mailing address
742 STERBENZ DR, HUDSON, WI 54016-8327
(715) 386-2128
(715) 386-6119
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3720
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3720
STATE LICENSE
WI
Enumeration date
09/07/2012
Last updated
12/18/2012
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