Provider Information for 1760881700
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EMILY KATE HEBERT BUCK LCSW
Other Names:Other Name:EMILY KATE BUCK LCSWSex: Female
NPI: 1760881700
Last Updated: 2022-07-10
Certification Date: 2022-07-10
Certification Date: 2022-07-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760881700 | ||||||||
| Enumeration Date | 2014-08-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 1320 GRIFFIN, GA 30224-0032 United States Phone: 770-358-5252 | Fax: | ||||||||
| Primary Practice Address | 463B ERNEST BILES DR JACKSON, GA 30233-2229 United States Phone: 770-358-5252 | Fax: | ||||||||
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