Candace Buckley
Clinic/Center, Mental Health (Including Community Mental Health Center) in Waukesha, WI. Organization (NPI-2).
NPI number1215332028
StatusActive
Last updated in NPPESOct 23, 2014
Details
- NPI
- 1215332028
- Entity type
- Organization (NPI-2)
- Legal business name
- Candace Buckley
- Organization subpart
- No
- Enumeration date
- Oct 23, 2014
- Last updated
- Oct 23, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | 7921 | WI | Yes |
Practice location
W228s2323 Oriole DrWaukesha, WI 53186-6371
Phone 262-501-0770
Mailing address
W228s2323 Oriole DrWaukesha, WI 53186-6371
Phone 262-501-0770
Authorized official
Candace Lynn Buckley
Social Worker
2625010770
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