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NPI Code Detail

MEDICARE: KALE TIMOTHY JORDON LPC

MEDICARE: KALE TIMOTHY JORDON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor62707TX

General Provider Information

NPI Number : 1861786170
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALE TIMOTHY JORDON LPC
Provider Business Mailing Address
First Line : 1731 N COMAL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-4214
Country : US
Telephone Number : 210-404-9399
Fax Number : 210-481-7175
Provider Business Practice Location Address
First Line : 1731 N COMAL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-4214
Country : US
Telephone Number : 210-404-9399
Fax Number : 210-481-7175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2011
Last Update Date : 06/03/2011

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Directions to “ KALE TIMOTHY JORDON LPC” Practice Location

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