Individual
MRS. KELLY BROOKE DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5509 POINT LAKE CT, HOLLY SPRINGS, NC 27540-9349
(919) 656-2901
(888) 893-4354
Mailing address
1914 KIRKWOOD RIDGE DR, RALEIGH, NC 27612-2877
(919) 710-6477
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7850
NC
Other
Enumeration date
02/05/2007
Last updated
08/29/2012
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