Healthcare Provider Details

I. General information

NPI: 1053073155
Provider Name (Legal Business Name): STEFANIE KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16815 ROYAL CREST DR
HOUSTON TX
77058-2521
US

IV. Provider business mailing address

723 MARBROOK SADDLE LN
LEAGUE CITY TX
77573-6836
US

V. Phone/Fax

Practice location:
  • Phone: 281-967-4019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number204105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: