Destiny Manwell
Behavior Technician in Dearborn, MI. Individual provider (NPI-1).
NPI number1003565243
StatusActive
Last updated in NPPESMar 23, 2022
Details
- NPI
- 1003565243
- Entity type
- Individual (NPI-1)
- Name
- Destiny Manwell
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2022
- Certification date
- Mar 23, 2022
- Last updated
- Mar 23, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1360 Porter StDearborn, MI 48124-2890
Phone 313-689-5188
Mailing address
1360 Porter StDearborn, MI 48124-2890
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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