Provider Demographics
NPI:1427285964
Name:JAMES, DENISE MARIE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
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 1:1353 ANTELOPE TRAIL
Mailing Address - Street 2:POB 1275
Mailing Address - City:SELIGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86337
Mailing Address - Country:US
Mailing Address - Phone:928-814-9196
Mailing Address - Fax:
Practice Address - Street 1:1353 ANTELOPE TRAIL
Practice Address - Street 2:
Practice Address - City:SELIGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86337
Practice Address - Country:US
Practice Address - Phone:928-814-9196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1446370385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child