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1417624859
LACEY JANE BUCKELEW
COSTA MESA, CA
NPI
1417624859
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 103434)
Enumeration Date
2021-08-24
Last Update Date
2022-08-15
Business Address
Mrs. LACEY JANE BUCKELEW ASW
301 VICTORIA ST
COSTA MESA, CA 92627-1995
Phone number: 949-574-3367
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Mailing Address
Mrs. LACEY JANE BUCKELEW ASW
PO BOX 735 1927 HARBOR BLVD.
COSTA MESA, CA 92627
Phone number: 714-651-1869
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