| Doctor Name: | DR. JOHN LARRY JANSKY |
| NPI Number: | 1184807141 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 856-057 |
| Business Practice Address: | N2846 State Road 67 Williams Bay, WI - 531913771 |
| Business Phone Number: | 2622455608 |
| Business Fax Number: | 2622455648 |
| Mailing Address: | N2846 State Road 67, WILLIAMS BAY |
| State: | WI |
| Postal Code: | 531913771 |
| Phone Number: | 2622455608 |
| Fax Number: | 2622455648 |
| NPI Enumeration Date: | 12/13/2007 |
| NPI Last Update Date: | 02/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 856-057 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |