Individual
MRS. WENDY C DESTASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
18578 COASTAL HWY, ACME, REHOBOTH BEACH, DE 19971-6154
(302) 644-1903
(302) 644-1906
Mailing address
PO BOX 324, NASSAU, DE 19969-0324
(302) 644-7530
(302) 644-7523
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
A1-0003346
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1-0003346
STATE LICENSE
DE
Enumeration date
02/19/2008
Last updated
01/11/2016
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