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1730641408
SHEA PROPHET
SAN DIEGO, CA
NPI
1730641408
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 121696)
Enumeration Date
2019-04-02
Last Update Date
2020-11-09
Business Address
SHEA PROPHET
6160 MISSION GORGE RD
SAN DIEGO, CA 92120-3410
Phone number: 194-813-7906
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Mailing Address
SHEA PROPHET
7525 PACIFIC AVE APT H
LEMON GROVE, CA 91945-2338
Phone number: 915-549-2339
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