Provider Demographics
NPI:1073324778
Name:CUSSEAUX, JANINE MICHAELA
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:MICHAELA
Last Name:CUSSEAUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 WISCONSIN AVE NW APT 102
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3814
Mailing Address - Country:US
Mailing Address - Phone:202-375-3046
Mailing Address - Fax:
Practice Address - Street 1:4040 FAIRFAX DR STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1613
Practice Address - Country:US
Practice Address - Phone:703-284-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program