Provider Demographics
NPI:1447046727
Name:KABO, JEAN JAYELLE
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:JAYELLE
Last Name:KABO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3244
Mailing Address - Country:US
Mailing Address - Phone:567-698-3326
Mailing Address - Fax:
Practice Address - Street 1:2065 GREEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3244
Practice Address - Country:US
Practice Address - Phone:567-698-3326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHVN407818251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health