| Doctor Name: | JESSICA BUCK |
| NPI Number: | 1043345408 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 001550 |
| Business Practice Address: | 984 Southford Rd Middlebury, CT - 067623234 |
| Business Phone Number: | 2037582400 |
| Business Fax Number: | 2037582415 |
| Mailing Address: | 16 Osborn Rd, LITCHFIELD |
| State: | CT |
| Postal Code: | 067592317 |
| Phone Number: | 8605674450 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001550 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |