Provider Demographics
NPI:1073077426
Name:JAMES, DANIELLE LEIGH (N/A)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEIGH
Last Name:JAMES
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17751 BEAUJOLAIS DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7517
Mailing Address - Country:US
Mailing Address - Phone:907-306-2580
Mailing Address - Fax:
Practice Address - Street 1:17751 BEAUJOLAIS DR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7517
Practice Address - Country:US
Practice Address - Phone:907-306-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator