Individual
DESTINY BROOKE CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
(360) 443-2399
Mailing address
1605 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
(360) 443-2399
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61329751
WA
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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