Provider Demographics
NPI:1730672049
Name:BUCKLEY, VALERIE (MA, CAS, PSYD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:MA, CAS, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13907 SPOONBILL ST N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-1388
Mailing Address - Country:US
Mailing Address - Phone:904-708-4963
Mailing Address - Fax:
Practice Address - Street 1:13907 SPOONBILL ST N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1388
Practice Address - Country:US
Practice Address - Phone:904-708-4963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1168103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool