Healthcare Provider Details

I. General information

NPI: 1407784994
Provider Name (Legal Business Name): DESTINY BLANDING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 ARBOR RD SW
CANTON OH
44710-2309
US

IV. Provider business mailing address

3407 ARBOR RD SW
CANTON OH
44710-2309
US

V. Phone/Fax

Practice location:
  • Phone: 330-812-1737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number602378191121
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: