Destiny Heaven Carree
Individual provider Active NPI Behavior Technician · Grosse Pointe Woods, MI
NPI 1376394635 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1376394635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 19251 Mack Ave
Grosse Pointe Woods, MI 48236-2893 - Phone
- (313) 373-1370
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
19251 Mack Ave
Grosse Pointe Woods, MI 48236-2893
Mailing address
19251 Mack Ave
Grosse Pointe Woods, MI 48236-2893
Other practice location 1
23663 Park St
Dearborn, MI 48124-2547
Phone (313) 689-5188
Other providers in Grosse Pointe Woods, MI
- Patricia Ann Camazzola
- Christopher Canon
- Aidan Jordan Cantor
- Katherine Lynn Caretti
- Carol J Quinn DDS PC
- Meredith Free Carrel
- Shelley Carter
- Thomas Charles Catrett III
- Angelina Cavaliere
- Ccla 6 LLC
All providers in Grosse Pointe Woods, MI · Behavior Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.