Individual
JEANETTE I LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5123 N 45TH ST, TACOMA, WA 98407-3717
(253) 792-1077
Mailing address
PO BOX 7899, TACOMA, WA 98417-0899
(253) 792-1077
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY23674
CA
103T00000X
Psychologist
Primary
PY60502318
WA
103TB0200X
Cognitive & Behavioral Psychologist
PSY23674
CA
Other
Enumeration date
09/09/2009
Last updated
02/12/2025
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