Healthcare Provider Details

I. General information

NPI: 1942985122
Provider Name (Legal Business Name): DESTINEE AIYANNA STALLARD MS. BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8951 COLLIN MCKINNEY PKWY STE 402
MCKINNEY TX
75070-8480
US

IV. Provider business mailing address

8951 COLLIN MCKINNEY PKWY STE 402
MCKINNEY TX
75070-8480
US

V. Phone/Fax

Practice location:
  • Phone: 469-300-0345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-85803
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: