| Mary Kay Buckley, Psychotherapist Inc | |
|
1357 W Shaw Ave Ste 102 Fresno CA 93711-3619 | |
| (559) 250-6715 | |
| (866) 812-5195 |
| Full Name | Mary Kay Buckley, Psychotherapist Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1357 W Shaw Ave Ste 102, Fresno, California |
| Authorized Official Name and Position | Mary Kathleen Buckley (OWNER/PROVIDER) |
| Authorized Official Contact | 5592506715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Kay Buckley, Psychotherapist Inc 1357 W Shaw Ave Ste 102 Fresno CA 93711-3619 Ph: (559) 250-6715 | Mary Kay Buckley, Psychotherapist Inc 1357 W Shaw Ave Ste 102 Fresno CA 93711-3619 Ph: (559) 250-6715 |
| NPI Number | 1710509377 |
|---|---|
| Provider Enumeration Date | 05/17/2020 |
| Last Update Date | 03/12/2022 |
| Certification Date | 03/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710509377 | NPI | - | NPPES |
| 7246041 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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