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General NPI Number Information
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NPI Number | 1639477623
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Entity Type | Individual
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Provider Name | LLOYD ROBERT BUCKNER JR. MS, BCBA
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Gender | Male
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Dates
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Enumeration Date | 03/01/2011
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 7022 LITTLE OAK CT
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City | LOUISVILLE
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State | KY
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Zip | 40291-4513
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Country | US
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Telephone | 502-714-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 NORTHLAND RD APT 76
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City | MOUNT DORA
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State | FL
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Zip | 32757-2362
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Country | US
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Telephone | 502-714-8300
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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