Provider Demographics
NPI:1386017846
Name:DITSLEAR, JANET LEIGH (MA, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEIGH
Last Name:DITSLEAR
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4922 E 161ST ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9239
Mailing Address - Country:US
Mailing Address - Phone:317-626-3757
Mailing Address - Fax:
Practice Address - Street 1:1212 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-9278
Practice Address - Country:US
Practice Address - Phone:317-316-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000202A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist