MR. Mark G Blackshear II

NPI #1114426525 in Lemon Grove, California

Provider Information

NPI Number: 1114426525
Entity Type: Individual
Name: MR. Mark G Blackshear II
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Enumeration Date: Feb 12, 2018
Last Updated: Feb 12, 2018

Practice Location

Address: 3434 GROVE ST
City: Lemon Grove
State: California
ZIP Code: 91945-1812
Phone: (619) 281-3706

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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