Individual
DESTINI KIRKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHCA, AAC
Contact information
Practice address
2204 PACIFIC AVE N, LONG BEACH, WA 98631-3300
(360) 642-2096
(360) 642-2096
Mailing address
2204 PACIFIC AVE N, LONG BEACH, WA 98631-3300
(360) 642-2096
(360) 642-2096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CG60521009
WA
101YM0800X
Mental Health Counselor
Primary
MC60820574
WA
Other
Enumeration date
02/09/2018
Last updated
02/09/2018
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