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Individual

DR. STEPHANIE MARY BUCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., MACP

Contact information

Practice address
831 S MILLS ST, MADISON, WI 53715-1851
(608) 886-6478
(866) 298-4159
Mailing address
831 S MILLS ST, MADISON, WI 53715-1851
(608) 886-6478
(866) 298-4159

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000236
VT
101YP2500X
Professional Counselor
4801-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891855409
WI
Enumeration date
12/12/2006
Last updated
12/03/2012
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