Provider Demographics
NPI:1043810781
Name:JAMES, MARINA KOGOT (MA)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:KOGOT
Last Name:JAMES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 NEW ST
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4511
Mailing Address - Country:US
Mailing Address - Phone:267-210-4909
Mailing Address - Fax:
Practice Address - Street 1:123 NEW ST
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4511
Practice Address - Country:US
Practice Address - Phone:267-210-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor