Individual provider · Type 1 NPI

Doretha Destefano, LGPC

Mental Health Counselor · Upper Marlboro, MD

NPI number 1508219155 Active

Practice location

14701 Governor Oden Bowie Dr
Upper Marlboro, MD 20772-3046

Call (301) 952-4455 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLGP6125 (MD)

Mental Health Counselor: Definition to come...

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About NPI 1508219155

Doretha Destefano, LGPC's National Provider Identifier is 1508219155, issued on Jul 19, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Upper Marlboro, MD. The record was last updated on Sep 29, 2016.