Provider Demographics
NPI:1326255639
Name:RITTER, JUSTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:
Last Name:RITTER
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 1:5900 MIDNIGHT PASS RD
Mailing Address - Street 2:Y-502
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-8708
Mailing Address - Country:US
Mailing Address - Phone:941-349-7011
Mailing Address - Fax:
Practice Address - Street 1:405 JULIA PL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6915
Practice Address - Country:US
Practice Address - Phone:941-321-2547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical