Organization
DESTINY OUTPATIENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN GEOR-ZELL BYNUM LPC (EXECUTIVE DIRECTOR)
(602) 327-8375
Entity
Organization
Contact information
Practice address
5308 N 17TH AVE, PHOENIX, AZ 85015-3035
(602) 249-6674
(602) 926-0590
Mailing address
5306 N 17TH AVE, PHOENIX, AZ 85015-3035
(602) 249-6674
(602) 926-0590
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC7551
AZ
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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