Provider Demographics
NPI:1689266520
Name:JAMES, ELAINE (LMT)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 SAINT PAUL ST # A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6036
Mailing Address - Country:US
Mailing Address - Phone:443-522-6907
Mailing Address - Fax:
Practice Address - Street 1:1919 SAINT PAUL ST # A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6036
Practice Address - Country:US
Practice Address - Phone:443-522-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225700000X
MDR02364225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist