Destefano, Doretha
Destefano, Doretha is an sole proprietor health care provider with primary practice located at 14701 Governor Oden Bowie Dr , Upper Marlboro MD 20772-3046. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Destefano, Doretha can be contacted via phone (301) 952-4455.Contact Information
Primary practice address
14701 Governor Oden Bowie Dr
Upper Marlboro MD 20772-3046
Phone: (301) 952-4455
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LGP6125 | Maryland |
Profile Details
| NPI number | 1508219155 |
|---|---|
| LBN Legal business name | Destefano, Doretha |
| Credentials | LGPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2016 |
| Last updated | Sep 29th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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