Individual
DESTANY KYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W EDISON RD, MISHAWAKA, IN 46545-3104
(574) 318-4984
(574) 318-4198
Mailing address
220 W EDISON RD, MISHAWAKA, IN 46545-3104
(574) 318-4984
(574) 318-4198
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
015259
IN
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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