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General NPI Number Information
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NPI Number | 1922322346
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Entity Type | Individual
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Provider Name | CHRISTINA DISTEFANO LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 2803 AKRON RD
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City | WOOSTER
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State | OH
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Zip | 44691-7904
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Country | US
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Telephone | 330-264-3232
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Fax | 330-202-3897
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Provider Business Mailing Address
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Address Line | 11401 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5428
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Country | US
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Telephone | 216-476-4277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0004278
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License Number State | OH
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