Provider Demographics
NPI:1720327448
Name:MILLINE-CARDENAS, KAMESHA DENISE (MSW)
Entity Type:Individual
Prefix:MS
First Name:KAMESHA
Middle Name:DENISE
Last Name:MILLINE-CARDENAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1593
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-1593
Mailing Address - Country:US
Mailing Address - Phone:907-434-2115
Mailing Address - Fax:
Practice Address - Street 1:306 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3344
Practice Address - Fax:907-443-7273
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor