Provider Demographics
NPI:1386006302
Name:KAMARA, ABDUL
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:KAMARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 WOODLYNNE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLYNNE
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-2235
Mailing Address - Country:US
Mailing Address - Phone:609-267-9339
Mailing Address - Fax:
Practice Address - Street 1:1818 WOODLYNNE AVE
Practice Address - Street 2:
Practice Address - City:WOODLYNNE
Practice Address - State:NJ
Practice Address - Zip Code:08107-2235
Practice Address - Country:US
Practice Address - Phone:609-267-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJK0338 00272 05692103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst