Basic Information
| Provider Information | |||||||||
| NPI: | 1700890589 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIGHT | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15550 ALDRICH LN | ||||||||
| Address2: | |||||||||
| City: | PERRY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660734020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858657512 | ||||||||
| FaxNumber: | 7855975044 | ||||||||
| Practice Location | |||||||||
| Address1: | 403 SYCAMORE ST | ||||||||
| Address2: | |||||||||
| City: | VALLEY FALLS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660881318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7859453263 | ||||||||
| FaxNumber: | 7855975044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 2001024790 | MO | N | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | 1141 | KS | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 495720807 | 05 | MO | MEDICAID | 200408060A | 05 | KS | MEDICAID |