# MR. PAUL LAWRENCE A DEFIESTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1184246597
- **Gender:** Man
- **Credential:** MSW, LCSWA, LMSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 10499-M | NV | Yes |
| 1041C0700X | Clinical Social Worker | P014490 | NC | — |

## Other

- **Enumeration date:** 05/08/2020
- **Last updated:** 04/18/2024