Healthcare Provider Details

I. General information

NPI: 1164342952
Provider Name (Legal Business Name): DESTINY PAIGE STREETER MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 COURT AVE STE 200
DES MOINES IA
50309-2230
US

IV. Provider business mailing address

309 COURT AVE STE 200
DES MOINES IA
50309-2230
US

V. Phone/Fax

Practice location:
  • Phone: 515-303-0787
  • Fax:
Mailing address:
  • Phone: 515-303-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: