Healthcare Provider Details

I. General information

NPI: 1861713208
Provider Name (Legal Business Name): KUMBA LEBBIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 PENWORTH DR
COLUMBUS OH
43229-5213
US

IV. Provider business mailing address

4808 WARMINSTER DR
COLUMBUS OH
43232-5359
US

V. Phone/Fax

Practice location:
  • Phone: 614-772-8279
  • Fax:
Mailing address:
  • Phone: 614-367-6037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: