Provider Demographics
NPI:1275376287
Name:KEITH, DESTINY SANCHEZ
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:SANCHEZ
Last Name:KEITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 SUNGROVE LN APT 225
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-9504
Mailing Address - Country:US
Mailing Address - Phone:919-696-2873
Mailing Address - Fax:
Practice Address - Street 1:3311 SUNGROVE LN APT 225
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-9504
Practice Address - Country:US
Practice Address - Phone:919-696-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical