Provider Demographics
NPI:1437455359
Name:SULTENFUSS, JANICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:SULTENFUSS
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 1:1228 N AUGUSTA ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3202
Mailing Address - Country:US
Mailing Address - Phone:540-885-5445
Mailing Address - Fax:540-885-5447
Practice Address - Street 1:1228 N AUGUSTA ST
Practice Address - Street 2:SUITE E
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3202
Practice Address - Country:US
Practice Address - Phone:540-885-5445
Practice Address - Fax:540-885-5447
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001579103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical