Provider Demographics
NPI:1073614111
Name:SPIRIDIGLIOZZI, JOHN V JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:V
Last Name:SPIRIDIGLIOZZI
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 MASSACHUSETTS ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-4257
Mailing Address - Country:US
Mailing Address - Phone:785-749-4442
Mailing Address - Fax:785-842-6007
Practice Address - Street 1:1711 MASSACHUSETTS ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-4257
Practice Address - Country:US
Practice Address - Phone:785-749-4442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS837103T00000X
MO384103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist