Healthcare Provider Details

I. General information

NPI: 1801481320
Provider Name (Legal Business Name): DESTINY GENWRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WEST ST SUITE #1200
WILMINGTON DE
19801
US

IV. Provider business mailing address

3023 STODDARD PL
WILMINGTON DE
19802-3226
US

V. Phone/Fax

Practice location:
  • Phone: 484-485-3598
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-82848
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: