Individual
DR. DWAYNE LAMONT BUCKINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.W, PHD
Contact information
Practice address
9524 BALTIMORE AVE, LAUREL, MD 20723-1816
(210) 382-2672
Mailing address
9524 BALTIMORE AVE, LAUREL, MD 20723
(210) 382-2672
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2006029483
MO
1041C0700X
Clinical Social Worker
Primary
22698
MD
1041C0700X
Clinical Social Worker
6801076311
MI
Other
Enumeration date
08/18/2005
Last updated
07/21/2022
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