Individual
SHELLON DESTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
974 SCHENECTADY AVE, BROOKLYN, NY 11203-4212
(929) 369-8121
Mailing address
974 SCHENECTADY AVE, BROOKLYN, NY 11203-4212
(929) 369-8121
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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