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Provider Information for 1750157897


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Ms. FAITH COMFORT MAMOMBE LCSW


Sex: Female

NPI: 1750157897
Last Updated: 2023-11-29
Certification Date: 2023-11-29

Details

NameValue
NPI1750157897
Enumeration Date2023-11-29
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 6927 SCENIC SUNSET
SAN ANTONIO, TX 78249-3515
United States

Phone: 251-751-9133 | Fax:
 
Primary Practice Address 9821 CAMINO VILLA APT 537
SAN ANTONIO, TX 78254-5623
United States

Phone: 251-751-9133 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalTX68947