Organization
BUTTERFLY EFFECTS
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS DARNELL SHANNON (BEHAVIORAL COUNSELOR)
(619) 565-0042
Entity
Organization
Contact information
Practice address
4650 34TH ST APT D, SAN DIEGO, CA 92116-3443
(619) 565-0042
Mailing address
4650 34TH STREET APT D, SAN DIEGO, CA 92116
(619) 565-0042
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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