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Individual

EMMA ELIZABETH BUCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
402 NW F ST, GRANTS PASS, OR 97526-1947
(541) 479-2966
Mailing address
201 W MAIN ST STE 4B, MEDFORD, OR 97501-2734

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/16/2019
Last updated
04/16/2019
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