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General NPI Number Information
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NPI Number | 1316248818
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Entity Type | Individual
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Provider Name | JOANNE BUCKLEY OTR
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Gender | Female
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 1500 ROUTE 488
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City | CLIFTON SPRINGS
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State | NY
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Zip | 14432-9308
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Country | US
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Telephone | 315-548-6971
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Fax |
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Provider Business Mailing Address
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Address Line | 11 BEACON ST
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City | GENEVA
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State | NY
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Zip | 14456-2701
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Country | US
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Telephone | 315-781-5833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 003685-1
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License Number State | NY
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