Individual
DESTINY BLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
224 RHETT AVE SW, HUNTSVILLE, AL 35801-4506
(938) 902-0494
Mailing address
224 RHETT AVE SW, HUNTSVILLE, AL 35801-4506
(938) 902-0494
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
ALC06022
AL
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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