Healthcare Provider Details

I. General information

NPI: 1235044603
Provider Name (Legal Business Name): DESTINY SOO HON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 INDEPENDENCE ST
CAPE GIRARDEAU MO
63703-5736
US

IV. Provider business mailing address

2126 W CAPE ROCK DR
CAPE GIRARDEAU MO
63701-2856
US

V. Phone/Fax

Practice location:
  • Phone: 573-986-0754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: