Individual
DESTINY STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5703 JACKSON ST APT 149, ALEXANDRIA, LA 71303-2020
(225) 955-6865
Mailing address
8326 KELWOOD AVE, BATON ROUGE, LA 70806-4803
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
08/13/2021
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