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Individual

PETER DESTEFANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
THERAPIST

Contact information

Practice address
13 HEATHER PL, SOUTHAMPTON, NJ 08088-1115
(640) 223-5172
Mailing address
13 HEATHER PL, SOUTHAMPTON, NJ 08088-1115

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00377900
NJ

Other

Enumeration date
11/10/2025
Last updated
11/10/2025
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