Individual
DESTINY YVONNE FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
1200 G ST NW STE 800, WASHINGTON, DC 20005-6705
(202) 794-7159
(855) 568-2494
Mailing address
18726 S WESTERN AVE, GARDENA, CA 90248-3813
(310) 856-0800
(855) 568-2494
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/25/2021
Last updated
09/25/2021
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