Individual
DOUGLAS P DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0414
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-7761
(602) 933-1813
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-21266
AZ
Other
Enumeration date
12/12/2022
Last updated
08/28/2023
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