MEDICARE: DESTINEE DEININGER 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
1	103K00000X	Behavior Analyst	1-26-89360	OH

General Provider Information

NPI Number	:	1558298026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINEE DEININGER BCBA

Provider Business Mailing Address
First Line	:	100 COMMERCIAL DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5556
Country	:	US
Telephone Number	:	513-874-6789
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 COMMERCIAL DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5556
Country	:	US
Telephone Number	:	513-874-6789
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ DESTINEE DEININGER BCBA” Practice Location

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