Provider Demographics
NPI:1912178930
Name:PITERA STUDER, JOANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:PITERA STUDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 FORMOSA TER
Mailing Address - Street 2:ACTIONS 4 LIFE, INC.
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2117
Mailing Address - Country:US
Mailing Address - Phone:941-782-7195
Mailing Address - Fax:877-307-6399
Practice Address - Street 1:2685 FORMOSA TERRACE
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-2117
Practice Address - Country:US
Practice Address - Phone:941-782-7195
Practice Address - Fax:877-307-6399
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 4421103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist