Individual
JOSEPHINE DISTAFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4905 LANTANA RD, LAKE WORTH, FL 33463-6915
(855) 408-5780
Mailing address
18099 92ND LN N, LOXAHATCHEE, FL 33470-5140
(856) 310-0555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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