Provider Demographics
NPI:1164659694
Name:JANOW, DONIELLE C D (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:DONIELLE
Middle Name:C D
Last Name:JANOW
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:DONIELLE
Other - Middle Name:C D
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-5636
Mailing Address - Fax:540-433-4123
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003879103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05754OtherRMH GROUP PTAN
VA1417027608OtherRMH GROUP NPI