Individual
DESTINEY BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2785 SOM CENTER RD, WILLOUGHBY HILLS, OH 44094-6501
(216) 278-0288
Mailing address
2785 SOM CENTER RD, WILLOUGHBY HILLS, OH 44094-6501
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881101780
—
TX
Enumeration date
08/11/2020
Last updated
08/11/2020
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