Organization
DESTINY THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LARONDA CHATMAN (OWNER)
(772) 359-1267
Entity
Organization
Contact information
Practice address
4186 OKEECHOBEE ROAD, SUITE 77, FORT PIERCE, FL 34947
(772) 359-1267
(772) 264-8224
Mailing address
4186 OKEECHOBEE ROAD, SUITE 77, FORT PIERCE, FL 34947
(772) 359-1267
(772) 264-8224
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111187900
—
FL
Enumeration date
07/28/2022
Last updated
07/28/2022
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