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NPI Code Detail

MEDICARE: DESTIN ELIJAH HINTON

MEDICARE: DESTIN ELIJAH HINTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianH535139209101MI

General Provider Information

NPI Number : 1528921343
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTIN ELIJAH HINTON
Provider Business Mailing Address
First Line : 23800 NORTHWESTERN HWY STE 190L
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-7740
Country : US
Telephone Number : 586-265-9355
Fax Number :
Provider Business Practice Location Address
First Line : 23800 NORTHWESTERN HWY STE 190L
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-7740
Country : US
Telephone Number : 586-265-9355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “ DESTIN ELIJAH HINTON ” Practice Location

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