Individual
DESTINEE BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1968 W ADAMS BLVD # 314, LOS ANGELES, CA 90018-3515
(269) 531-0553
Mailing address
4255 7TH AVE, LOS ANGELES, CA 90008-4704
(323) 823-0517
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
CA
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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