Individual
BRENNA NATALIA DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
024161
NY
225X00000X
Occupational Therapist
Primary
5274
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024161
NY STATE EDUCATION DEPARTMENT OFFICE OF PROFESSION
NY
01
—
5274
CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
11/25/2019
Last updated
11/25/2019
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