Individual
DESTINI FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
919 MEDICAL DR STE 1200, ALLEN, TX 75013-5756
(214) 505-9984
Mailing address
919 MEDICAL DR STE 1200, ALLEN, TX 75013-5756
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
TX
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/14/2020
Last updated
12/10/2024
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