Individual
DESTINEE BOHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24328 VERMONT AVE STE 318, HARBOR CITY, CA 90710-2314
(424) 250-9615
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
235Z00000X
Speech-Language Pathologist
Primary
42015
CA
Other
Enumeration date
12/30/2021
Last updated
08/06/2026
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