Individual
DR. ROWAN P BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6825 OWEN ST STE 201, LORETTO, MN 55357-9713
(612) 916-1147
Mailing address
6825 OWEN ST STE 201, LORETTO, MN 55357-9713
(612) 916-1147
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
5599
MN
103TC0700X
Clinical Psychologist
Primary
5599
MN
103TC2200X
Clinical Child & Adolescent Psychologist
5599
MN
103TF0000X
Family Psychologist
5599
MN
103TM1800X
Intellectual & Developmental Disabilities Psychologist
5599
MN
103TR0400X
Rehabilitation Psychologist
5599
MN
Other
Enumeration date
07/01/2013
Last updated
07/09/2020
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