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Destiny Renea Long

Behavior Analyst in Alexandria, VA. Individual provider (NPI-1).

NPI number1366094575
StatusActive
Last updated in NPPESApr 15, 2022

Details

NPI
1366094575
Entity type
Individual (NPI-1)
Name
Destiny Renea Long
Sex
Female
Sole proprietor
No
Enumeration date
Jul 9, 2019
Certification date
Apr 15, 2022
Last updated
Apr 15, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst0133002335VAYes
106S00000X Behavior TechnicianRBT-19-91203VA

Practice location

5810 Kingstowne Ctr Ste 921
Alexandria, VA 22315-5732

Phone 207-478-1951

Mailing address

3654 Edenberry Ct
Virginia Beach, VA 23452-8208

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