Individual
MIA MARIE DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
169 ALBANY TPKE STE 4B, CANTON, CT 06019-2511
(860) 626-5110
Mailing address
218 NEW BRITAIN AVE APT 5, UNIONVILLE, CT 06085-1272
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8258
CT
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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