Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor |
NPI | 1003086869 |
---|---|
Provider Name | Shannon Cousins-Kamara |
First Address | Sacramento, CA 95823-7320 |
Second Address | Sacramento, CA 95825-4731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2008 |
Last Update Date | 14/09/2018 |