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1154799773
SHANNON MARTIN
SACRAMENTO, CA
NPI
1154799773
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: R1194201315)
Enumeration Date
2015-09-14
Last Update Date
2019-10-17
Business Address
SHANNON MARTIN
310 HARRIS AVE SUITE A
SACRAMENTO, CA 95838
Phone number: 916-649-6793
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Mailing Address
SHANNON MARTIN
310 HARRIS AVE SUITE A
SACRAMENTO, CA 95838-3249
Phone number: 916-649-6793
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