Individual
SHEILA STAR COULBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
11011 VIA FRONTERA, SUITE A, SAN DIEGO, CA 92127-1752
(619) 980-9591
Mailing address
PO BOX 720368, SAN DIEGO, CA 92172-0368
(619) 980-9591
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4762
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4762
CERTIFIED MASSAGE THERAPIST
CA
Enumeration date
06/01/2012
Last updated
06/12/2013
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