Individual
GINA MARIE DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
129 S CARSON RD, BEVERLY HILLS, CA 90211-2901
(516) 241-0999
Mailing address
129 S CARSON RD, BEVERLY HILLS, CA 90211-2901
(516) 241-0999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
23465
CA
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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