Healthcare Provider Details

I. General information

NPI: 1609369735
Provider Name (Legal Business Name): DESTINY HARDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESTINY WATTS CAA

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date: 05/02/2026
Reactivation Date: 08/03/2026

III. Provider practice location address

900 23RD ST NW
WASHINGTON DC
20037-2342
US

IV. Provider business mailing address

2300 M ST NW FL 7
WASHINGTON DC
20037-1434
US

V. Phone/Fax

Practice location:
  • Phone: 202-823-4220
  • Fax:
Mailing address:
  • Phone: 202-823-4220
  • Fax: 202-823-4221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: