Individual
MRS. AMY LYNNE BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
646 MAIN STREET, PORT JEFFERSON, NY 11777
(631) 942-5733
Mailing address
19 VIEW ROAD, SETAUKET, NY 11733
(631) 675-6565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
069255
NY
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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