Individual
DESTINY TERTOCHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 E MOUND RD STE 100, DECATUR, IL 62526-2771
(217) 970-2040
Mailing address
1301 E MOUND RD STE 100, DECATUR, IL 62526-2771
(217) 970-2040
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-404815
IL
Other
Enumeration date
07/08/2026
Last updated
07/08/2026
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