LACY LONG BUCKNER

SHREVEPORT, LA
NPI1891421590
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2022-07-26
Last Update Date2023-10-06
Business Address
LACY LONG BUCKNER
2000 FAIRFIELD AVE
SHREVEPORT, LA 71104-2099
Phone number: 318-222-8511
Mailing Address
LACY LONG BUCKNER
2000 FAIRFIELD AVE
SHREVEPORT, LA 71104-2099
Phone number: 318-222-8511