Individual
DESTINY WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 2ND LOOP RD, FLORENCE, SC 29505-2814
(843) 536-8674
Mailing address
2580 LIN DO CT, SUMTER, SC 29150-1832
(803) 905-4427
(803) 905-4431
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-53124
SC
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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