| Doctor Name: | CAROL BUCKNER |
| NPI Number: | 1427427871 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6801095808 |
| Business Practice Address: | 4205 Charlar Dr Ste. 3 Holt, MI - 488426810 |
| Business Phone Number: | 5173670670 |
| Business Fax Number: | 5173670681 |
| Mailing Address: | 4205 Charlar Dr, Ste. 3 HOLT |
| State: | MI |
| Postal Code: | 488426809 |
| Phone Number: | 5173670670 |
| Fax Number: | 5173670681 |
| NPI Enumeration Date: | 09/16/2015 |
| NPI Last Update Date: | 09/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801095808 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |