Individual provider · Type 1 NPI
Nicole Marie Destefano
Mental Health Counselor · Worcester, MA
NPI number
1881307668
Active
Practice location
135 Gold Star Blvd
Worcester, MA 01606-2738
Mailing address
5 Keene St
North Smithfield, RI 02896-8145
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | None listed |
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1881307668
Nicole Marie Destefano's National Provider Identifier is 1881307668, issued on Dec 27, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Worcester, MA. The record was last updated on Dec 27, 2022.