Individual
JACQUES KYANZA KYAGILO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19220 VAN AKEN BLVD APT 303, SHAKER HEIGHTS, OH 44122-3557
(832) 258-7367
Mailing address
19220 VAN AKEN BLVD APT 303, SHAKER HEIGHTS, OH 44122-3557
(832) 258-7367
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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