Provider Demographics
NPI:1164049532
Name:JAMES, DENISE WILLIAMS (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:WILLIAMS
Last Name:JAMES
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28090-0744
Mailing Address - Country:US
Mailing Address - Phone:980-295-9170
Mailing Address - Fax:
Practice Address - Street 1:150 FALLS ST
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:NC
Practice Address - Zip Code:28090-9582
Practice Address - Country:US
Practice Address - Phone:980-295-9170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC-737651744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management