Provider Demographics
NPI:1316519416
Name:KABWASA, MWAUKA SOLEITA (CD-L)
Entity type:Individual
Prefix:
First Name:MWAUKA
Middle Name:SOLEITA
Last Name:KABWASA
Suffix:
Gender:F
Credentials:CD-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1877 MADISON ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3844
Mailing Address - Country:US
Mailing Address - Phone:347-968-2785
Mailing Address - Fax:
Practice Address - Street 1:1877 MADISON ST APT 2R
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11385-3844
Practice Address - Country:US
Practice Address - Phone:347-968-2785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty