Individual
DESTINY L MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 23RD ST NW, WASHINGTON, DC 20037-2342
(202) 715-4000
(202) 715-4015
Mailing address
2309 SHOREFIELD RD APT 122, SILVER SPRING, MD 20902-1853
(240) 425-3791
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/05/2021
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