Individual
DESTINY CRISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 EXECUTIVE MEADOWS DR, LENOIR CITY, TN 37771-6775
(865) 934-9588
Mailing address
159 EXECUTIVE MEADOWS DR, LENOIR CITY, TN 37771-6775
(865) 934-9588
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
24-391209
TN
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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