Provider Demographics
NPI:1659088540
Name:PERKINS, JANELLE ROSE
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:ROSE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:ROSE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 MINERAL POND CT
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1049
Mailing Address - Country:US
Mailing Address - Phone:612-275-2244
Mailing Address - Fax:
Practice Address - Street 1:435 MINERAL POND CT
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-1049
Practice Address - Country:US
Practice Address - Phone:612-275-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst