Individual
DESTINY SHANELE CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
140 ZION RD, GRETNA, VA 24557-4632
(434) 630-8629
Mailing address
140 ZION RD, GRETNA, VA 24557-4632
(434) 630-8629
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
253150
VA
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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