Destiny C Faulconer
Counselor, Mental Health in Vancouver, WA. Individual provider (NPI-1).
NPI number1467095877
StatusActive
Last updated in NPPESOct 18, 2019
Details
- NPI
- 1467095877
- Entity type
- Individual (NPI-1)
- Name
- Destiny C Faulconer
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 18, 2019
- Last updated
- Oct 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
1601 E Fourth Plain Blvd Bldg 17Vancouver, WA 98661-3717
Phone 360-397-8484 · Fax 360-397-8494
Mailing address
Po Box 1845Vancouver, WA 98668-1845
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