Provider Demographics
NPI:1679264766
Name:MAJETTE, DAEJAH
Entity Type:Individual
Prefix:
First Name:DAEJAH
Middle Name:
Last Name:MAJETTE
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 1:2607 COLONIAL AVE APT 128
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1339
Mailing Address - Country:US
Mailing Address - Phone:757-295-6774
Mailing Address - Fax:
Practice Address - Street 1:293 INDEPENDENCE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5461
Practice Address - Country:US
Practice Address - Phone:757-785-3338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician