Individual
DESTINY BROADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
98 E LAKE MEAD PKWY STE 105, HENDERSON, NV 89015-6443
(702) 861-1183
Mailing address
5815 NUEVO LEON ST UNIT 7, NORTH LAS VEGAS, NV 89031-4100
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A2181
NV
Other
Enumeration date
11/08/2017
Last updated
01/18/2021
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