Provider Demographics
NPI:1750520144
Name:SCHROLL, DESTINY LEANN
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:LEANN
Last Name:SCHROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 SE BARRINGTON DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3200
Mailing Address - Country:US
Mailing Address - Phone:866-240-0808
Mailing Address - Fax:866-240-0809
Practice Address - Street 1:231 SE BARRINGTON DR
Practice Address - Street 2:SUITE 203
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3200
Practice Address - Country:US
Practice Address - Phone:866-240-0808
Practice Address - Fax:866-240-0809
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst