Provider Demographics
NPI:1720365950
Name:JAMES, MAUREEN ANN (LPC #00191)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC #00191
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:ANN
Other - Last Name:MOZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3440 GOLFVIEW DR
Mailing Address - Street 2:#308
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2439
Mailing Address - Country:US
Mailing Address - Phone:651-675-0594
Mailing Address - Fax:
Practice Address - Street 1:3440 GOLFVIEW DR
Practice Address - Street 2:#308
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2439
Practice Address - Country:US
Practice Address - Phone:651-675-0594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health