Individual
DESTINEE MEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6409 E MILL PLAIN BLVD, VANCOUVER, WA 98661-7454
(360) 718-8376
Mailing address
11301 NE 7TH ST APT J09, VANCOUVER, WA 98684-4946
(805) 235-5850
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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