Healthcare Provider Details

I. General information

NPI: 1942113089
Provider Name (Legal Business Name): DESTINY O'GARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 POND ST
NORWELL MA
02061-1627
US

IV. Provider business mailing address

45 POND ST
NORWELL MA
02061-1627
US

V. Phone/Fax

Practice location:
  • Phone: 617-583-2883
  • Fax: 617-583-2883
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: