| Doctor Name: | DR. JAMES W SIDDALL |
| NPI Number: | 1144209834 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 85201 |
| Business Practice Address: | 4057 Cleveland Massillon Rd Norton, OH - 442035638 |
| Business Phone Number: | 3308255734 |
| Business Fax Number: | 3308255151 |
| Mailing Address: | 4057 Cleveland Massillon Rd, NORTON |
| State: | OH |
| Postal Code: | 442035638 |
| Phone Number: | 3308255734 |
| Fax Number: | 3308255151 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 85201 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |