Basic Information
| Provider Information | |||||||||
| NPI: | 1053941450 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUMEKPOR | ||||||||
| FirstName: | NOVINYO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3774 PINEBROOK HOLLOW LN | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773864309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729539001 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2929 FM 2920 RD | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773883428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812101500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2020 | ||||||||
| LastUpdateDate: | 01/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.