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General NPI Number Information
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NPI Number | 1912057514
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Entity Type | Individual
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Provider Name | SARA LYNN BUCKNAM
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 45 HIGH ST
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City | NASHUA
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State | NH
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Zip | 03060-3312
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Country | US
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Telephone | 603-821-7788
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Fax | 603-821-5620
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Provider Business Mailing Address
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Address Line | 77 NORTHEASTERN BLVD
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City | NASHUA
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State | NH
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Zip | 03062-3161
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Country | US
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Telephone | 603-882-3616
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Fax | 603-595-7414
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1024
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License Number State | NH
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