Individual
DESTYNI MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7648 BROCKTON RD, PHILADELPHIA, PA 19151-2826
(267) 978-8710
Mailing address
7648 BROCKTON RD, PHILADELPHIA, PA 19151-2826
(267) 978-8710
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2025
Last updated
05/26/2025
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