MEDICARE: DESTINY L WINANS

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

General Provider Information

NPI Number	:	1659966893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESTINY L WINANS

Provider Business Mailing Address
First Line	:	1523 BENT OAK DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-5106
Country	:	US
Telephone Number	:	254-366-1805
Fax Number	:

Provider Business Practice Location Address
First Line	:	1523 BENT OAK DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-5106
Country	:	US
Telephone Number	:	254-366-1805
Fax Number	:

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

Provider Enumeration Date	:	03/09/2021
Last Update Date	:	03/09/2021

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Directions to “ DESTINY L WINANS ” Practice Location

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