Destefano, Michael A

Destefano, Michael A is an individual health care provider with primary practice located at 14 S Bryn Mawr Ave Suite 205, Bryn Mawr PA 19010-3216. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Destefano, Michael A can be contacted via phone (610) 525-4828.

Contact Information

Primary practice address
14 S Bryn Mawr Ave Suite 205 Bryn Mawr PA 19010-3216
Phone: (610) 525-4828
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS004910L Pennsylvania
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS004910L Pennsylvania
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PS004910L Pennsylvania

Profile Details

NPI number 1982972378
LBN Legal business name Destefano, Michael A
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2011
Last updated Dec 13th, 2011 - about 15 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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