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Organization
MARISA P DISTEFANO LPC LLC
Active
Organization
MARISA P DISTEFANO LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARISA DISTEFANO LPC (OWNER)
(201) 446-4669
Entity
Organization
Contact information
Practice address
172 FRANKLIN AVE STE 4B, RIDGEWOOD, NJ 07450-3229
(201) 446-4669
Mailing address
172 FRANKLIN AVE STE 4B, RIDGEWOOD, NJ 07450-3229
(201) 446-4669
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/27/2024
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