| NPI | 1902430283 |
|---|---|
| Doing Business As | DESTINATION COUNSELING, LICENSED CLINICAL SOCIAL WORKER |
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD RUSS President 805-699-5381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |