Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1245890573 |
---|---|
Provider Name | Stephen Kabah |
First Address | San Antonio, TX 78228-1128 |
Second Address | San Antonio, TX 78228-1128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2019 |
Last Update Date | 18/06/2019 |