Individual
STEPHANI DESKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
9115 SW OLESON RD, PORTLAND, OR 97223
(971) 236-0915
Mailing address
921 14TH AVE, LONGVIEW, WA 98632-2316
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
10/28/2020
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