Provider Demographics
NPI:1952721912
Name:BUCKLAND, JESSICA (PSY D)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:BUCKLAND
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ROLLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7641
Mailing Address - Country:US
Mailing Address - Phone:814-867-0670
Mailing Address - Fax:
Practice Address - Street 1:320 ROLLING RIDGE DR
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7641
Practice Address - Country:US
Practice Address - Phone:814-867-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017577103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical