DESTINY LACARA MACK

EAST POINT, GA
NPI1043864432
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: GA  PCET004155)
Additional Taxonomies2355S0801X Specialist/Technologist, Speech-Language Assistant
(Licence: GA  SLPA000396)
Enumeration Date2019-07-24
Last Update Date2025-02-20
Business Address
DESTINY LACARA MACK
3485 N DESERT DR STE 105
EAST POINT, GA 30344-5724
Phone number: 678-724-7033
Mailing Address
DESTINY LACARA MACK
11009 SOUTHWOOD DR
HAMPTON, GA 30228-3498
Phone number: 404-831-2098