Individual
DESTINY C FAULCONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 98661-3717
(360) 397-8484
(360) 397-8494
Mailing address
PO BOX 1845, VANCOUVER, WA 98668-1845
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
10/18/2019
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