Individual
SHANNON COUSINS-KAMARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
650 HOWE AVE, SACRAMENTO, CA 95825-4731
(916) 993-4131
Mailing address
149 CINEMA ST, SACRAMENTO, CA 95823-7320
(916) 991-2641
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/07/2008
Last updated
09/14/2018
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