Individual
LATRICIA BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3751 PENNRIDGE DR STE 113, BRIDGETON, MO 63044-1244
(314) 570-2862
Mailing address
3751 PENNRIDGE DR STE 113, BRIDGETON, MO 63044-1244
(314) 570-2862
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014027994
MO
Other
Enumeration date
09/15/2014
Last updated
08/13/2021
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