Individual
MR. JUSTIN ROBERT DEFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
421 PASADENA DR, MCKEESPORT, PA 15133-3615
(412) 480-8683
Mailing address
421 PASADENA DR, MCKEESPORT, PA 15133-3615
(412) 480-8683
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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