Individual
BROOKE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
969 FRAYSER BLVD, MEMPHIS, TN 38127-5977
(760) 803-7030
Mailing address
59 N ASHLAWN RD, MEMPHIS, TN 38112-4306
(760) 803-7030
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
172V00000X
Community Health Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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