Provider Demographics
NPI:1639477623
Name:BUCKNER, LLOYD ROBERT JR (MS, BCBA)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:ROBERT
Last Name:BUCKNER
Suffix:JR
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 NORTHLAND RD
Mailing Address - Street 2:APT 76
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-2362
Mailing Address - Country:US
Mailing Address - Phone:502-714-8300
Mailing Address - Fax:
Practice Address - Street 1:7022 LITTLE OAK CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-4513
Practice Address - Country:US
Practice Address - Phone:502-714-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst