Provider Demographics
NPI:1164710752
Name:BUCKLEY, CHLOE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CHLOE
Other - Middle Name:
Other - Last Name:TELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:401 KAMAKEE ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4203
Mailing Address - Country:US
Mailing Address - Phone:808-277-8295
Mailing Address - Fax:
Practice Address - Street 1:401 KAMAKEE ST
Practice Address - Street 2:SUITE 405
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4203
Practice Address - Country:US
Practice Address - Phone:808-277-8295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY 1481103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical