| Specialty | Taxonomy Code | |
|---|---|---|
| * | Professional | 101YP2500X |
| Community/Behavioral Health | 251S00000X | |
| Mental Health | 101YM0800X | |
| Preferred Provider Organization | 305R00000X |
* Indicates primary specialty
| NPI Number | 1669861043 |
| Legal business name LBN |
CREATOR DESTINY LLC |
| Authorized official | YOLANDA BONNER - (OWNER) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 01/22/2015 |
| Last updated | 03/09/2015 - About 11 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
|
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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