Individual
DESTINY SKYE PHERNETTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S ., BCBA
Contact information
Practice address
5325 WALL ST STE 1000, MADISON, WI 53718-7983
(855) 444-5664
Mailing address
901 WHALEN RD STE A, VERONA, WI 53593-1766
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1250-140
WI
106S00000X
Behavior Technician
RBT-19-90748
IN
Other
Enumeration date
08/12/2019
Last updated
07/16/2024
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