Provider Demographics
NPI:1386886653
Name:JAMES, MICHELLE D
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:D
Last Name:JAMES
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 1:77650 H AND H STREET
Mailing Address - Street 2:
Mailing Address - City:MARINGOUIN
Mailing Address - State:LA
Mailing Address - Zip Code:70757-0299
Mailing Address - Country:US
Mailing Address - Phone:225-806-2854
Mailing Address - Fax:225-625-3358
Practice Address - Street 1:77650 H AND H STREET
Practice Address - Street 2:
Practice Address - City:MARINGOUIN
Practice Address - State:LA
Practice Address - Zip Code:70757-0299
Practice Address - Country:US
Practice Address - Phone:225-806-2854
Practice Address - Fax:225-625-3358
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children