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General NPI Number Information
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NPI Number | 1376707240
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Entity Type | Individual
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Provider Name | JAMES MITCHELL BUCCIGROSS PH.D., DABPS
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4450 BELDEN VILLAGE ST NW STE 211
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City | CANTON
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State | OH
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Zip | 44718-2596
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Country | US
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Telephone | 330-606-6119
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Fax | 330-238-1609
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Provider Business Mailing Address
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Address Line | 4450 BELDEN VILLAGE ST NW
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City | CANTON
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State | OH
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Zip | 44718-2552
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Country | US
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Telephone | 330-606-6119
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 4859
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 4859
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4859
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License Number State | OH
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