Doctor Name: | DR. PAMELA RENA' BUCK |
NPI Number: | 1720397417 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | P0000002293 |
Business Practice Address: | 408 W Main St Senatobia, MS - 386682153 |
Business Phone Number: | 9018277303 |
Business Fax Number: | |
Mailing Address: | 1854 Country Club Rd, SENATOBIA |
State: | MS |
Postal Code: | 386686378 |
Phone Number: | 6625609443 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2010 |
NPI Last Update Date: | 09/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | P0000002293 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |