Provider Demographics
NPI:1346332491
Name:BUCKNOR, PAULA ANDRIA (BA)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANDRIA
Last Name:BUCKNOR
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:511 7TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5435
Mailing Address - Country:US
Mailing Address - Phone:732-869-2770
Mailing Address - Fax:732-897-9541
Practice Address - Street 1:1011 BOND ST
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5939
Practice Address - Country:US
Practice Address - Phone:732-869-2770
Practice Address - Fax:732-897-9541
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health