Individual
AQUA STEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1006 NW 47TH ST STE B, LAWTON, OK 73505-4759
(858) 352-8840
Mailing address
PO BOX 674, HAWTHORNE, CA 90251-0674
(858) 352-8840
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
112500
CA
1041C0700X
Clinical Social Worker
20105
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/26/2016
Last updated
04/18/2025
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