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NPI Code Detail

MEDICARE: DESTINY DAYNICE WEBB M.ED, BCBA

MEDICARE: DESTINY DAYNICE WEBB M.ED, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-25-83712OTHERVABCBA CERTIFICATION

General Provider Information

NPI Number : 1417599903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY DAYNICE WEBB M.ED, BCBA
Provider Business Mailing Address
First Line : 4250 FAIRFAX DR
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1665
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4250 FAIRFAX DR
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1665
Country : US
Telephone Number : 804-207-3878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2019
Last Update Date : 08/27/2025

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