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Individual

MRS. DESTINY FAITH DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2091 SAMS ELBOW RD, WEST COLUMBIA, SC 29170-1114
(803) 477-7136
Mailing address
328 JOSHUA TREE CT, BLYTHEWOOD, SC 29016-7203

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary

Other

Enumeration date
09/16/2017
Last updated
09/16/2017
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