Individual
JESSICA DISTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAC
Contact information
Practice address
800 W MAIN ST STE 205, FREEHOLD, NJ 07728-2555
(732) 655-6331
Mailing address
706 LAREINE AVE UNIT 318, BRADLEY BEACH, NJ 07720-1065
(732) 674-3255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00782300
NJ
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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