Provider Demographics
NPI:1548985187
Name:WILLIAMS, DESTINEY (BCBA)
Entity type:Individual
Prefix:
First Name:DESTINEY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7735 FARROW PASS CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-4792
Mailing Address - Country:US
Mailing Address - Phone:678-814-5006
Mailing Address - Fax:
Practice Address - Street 1:7735 FARROW PASS CIR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30028-4792
Practice Address - Country:US
Practice Address - Phone:678-814-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst