Provider Demographics
NPI:1215808662
Name:JAMES, KANIAH (LMT)
Entity type:Individual
Prefix:
First Name:KANIAH
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HOLLY PARK LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-9675
Mailing Address - Country:US
Mailing Address - Phone:302-396-8777
Mailing Address - Fax:
Practice Address - Street 1:2 LEE AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-2149
Practice Address - Country:US
Practice Address - Phone:302-309-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0015304225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist