DESTINY LACARA MACK NPI 1043864432

NPI Information

NPI: 1043864432
Provider Name: DESTINY LACARA MACK
Classification: Specialist/Technologist - 2355S0801X
Entity Type: Individual

Specialization: Speech-Language Assistant

Address:
160 ROBERTS DR
RIVERDALE, GA
ZIP 30274
Phone: (770) 473-2905
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Destiny Lacara Mack is a speech-language assistant specialist technologist in Riverdale, GA. Destiny Lacara Mack NPI is 1043864432. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

160 ROBERTS DR
RIVERDALE, GA
ZIP 30274-302
Phone: (770) 473-2905
Fax: (770) 473-2913

The enumeration date for this NPI number is 7/24/2019 and was last updated on 7/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2355S0801X	Specialist/Technologist	Speech-Language Assistant	SLPA000396	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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