Provider Demographics
NPI:1598484446
Name:JAMES, NETEYAH DEANGELA
Entity Type:Individual
Prefix:
First Name:NETEYAH
Middle Name:DEANGELA
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 1:4261 SHERIDAN AVE S APT 207
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1619
Mailing Address - Country:US
Mailing Address - Phone:651-335-1437
Mailing Address - Fax:
Practice Address - Street 1:4261 SHERIDAN AVE S APT 207
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1619
Practice Address - Country:US
Practice Address - Phone:651-335-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician