Individual
JAIME DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
16820 MACANTHRA DR, CHARLOTTE, NC 28213-4879
(612) 987-0375
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9148
NC
Other
Enumeration date
04/15/2014
Last updated
08/02/2023
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