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Individual
MR. MATTHEW JOHN DISTEFANO
Active
Individual
MR. MATTHEW JOHN DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, NCC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2037
WV
101YP2500X
Professional Counselor
Primary
PC005413
PA
Other
Enumeration date
05/13/2008
Last updated
04/20/2012
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