Individual
CHARLEEN DE STEFANO
Active
Individual
CHARLEEN DE STEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
120197
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
MA
Enumeration date
04/11/2018
Last updated
04/11/2018
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