Provider Demographics
NPI:1427212588
Name:RINGWALD JOHANSSON, JANICE RINGWALD (PSYD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:RINGWALD
Last Name:RINGWALD JOHANSSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JANICE
Other - Middle Name:ELLEN
Other - Last Name:JOHANSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:30 S SHUMWAY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-2499
Mailing Address - Country:US
Mailing Address - Phone:630-879-8175
Mailing Address - Fax:
Practice Address - Street 1:30 S SHUMWAY AVE STE 1
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2499
Practice Address - Country:US
Practice Address - Phone:630-879-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health