Healthcare Provider Details

I. General information

NPI: 1295663946
Provider Name (Legal Business Name): DESTINI BENNETT RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 13TH ST
COLUMBUS GA
31901-2248
US

IV. Provider business mailing address

2303 BEATRICE AVE
COLUMBUS GA
31903-3512
US

V. Phone/Fax

Practice location:
  • Phone: 706-225-0101
  • Fax:
Mailing address:
  • Phone: 762-248-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: