Individual
DESTINY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1142 WILLAGILLESPIE RD STE 9, EUGENE, OR 97401-2142
(541) 666-3652
Mailing address
1142 WILLAGILLESPIE RD STE 9, EUGENE, OR 97401-2142
(541) 666-3652
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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