Individual
MRS. AIMEE KOCH BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC/ SLP
Contact information
Practice address
125 CHANTICLEER DR, PEARL RIVER, LA 70452-6320
(985) 641-2426
Mailing address
125 CHANTICLEER DR, PEARL RIVER, LA 70452-6320
(985) 641-2426
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4761
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473413
—
LA
Enumeration date
02/15/2008
Last updated
02/15/2008
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