Provider Demographics
NPI:1467881102
Name:KUKWA, JAMES KEMAH
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KEMAH
Last Name:KUKWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 ENGLISH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-1129
Mailing Address - Country:US
Mailing Address - Phone:652-262-7877
Mailing Address - Fax:
Practice Address - Street 1:1670 ENGLISH ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-1129
Practice Address - Country:US
Practice Address - Phone:652-262-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker