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Individual

MS. DESTINY MARIE BANKHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPSC

Contact information

Practice address
10011 SE DIVISION ST, SUITE # 305, PORTLAND, OR 97266-1351
(503) 335-5975
(503) 335-5974
Mailing address
3500 SE OAK GROVE BLVD APT 27, MILWAUKIE, OR 97267-1474
(503) 935-3226

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
07/24/2012
Last updated
07/24/2012
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