Provider Demographics
NPI:1124812706
Name:NGEZEM, DESTINY NKEMAYIM (DNN)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:NKEMAYIM
Last Name:NGEZEM
Suffix:
Gender:
Credentials:DNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 BAIRSFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3096
Mailing Address - Country:US
Mailing Address - Phone:614-715-7959
Mailing Address - Fax:614-715-7959
Practice Address - Street 1:1925 BAIRSFORD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-3096
Practice Address - Country:US
Practice Address - Phone:614-715-7959
Practice Address - Fax:614-715-7959
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst