Provider Demographics
NPI:1184671935
Name:HUNTOON, JANIS LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:LYNN
Last Name:HUNTOON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 YELLOWSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2647
Mailing Address - Country:US
Mailing Address - Phone:785-843-7410
Mailing Address - Fax:785-843-7410
Practice Address - Street 1:1017 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2917
Practice Address - Country:US
Practice Address - Phone:785-749-1563
Practice Address - Fax:785-843-3219
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS895103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS119827Medicare ID - Type Unspecified