Individual
MS. DORETHA DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
14701 GOVERNOR ODEN BOWIE DR, UPPER MARLBORO, MD 20772-3046
(301) 952-4455
Mailing address
14701 GOVERNOR ODEN BOWIE DR, UPPER MARLBORO, MD 20772-3046
(301) 952-4455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP6125
MD
Other
Enumeration date
07/19/2016
Last updated
09/29/2016
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