Destanee Black
NPI #1861089443 in Fort Totten, North Dakota
Provider Information
- NPI Number
- 1861089443
- Entity Type
- Individual
- Name
- Destanee Black
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician - Personal Care Attendant
- Enumeration Date
- Dec 29, 2020
- Last Updated
- Dec 29, 2020
Practice Location
- Address
- 63 HOUSING CIRCLE DR
- City
- Fort Totten
- State
- North Dakota
- ZIP Code
- 58335-3525
- Phone
- (701) 766-4382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician - Personal Care Attendant — Personal Care Attendant |
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