Provider Demographics
NPI:1952038572
Name:DESTEFANO CONSULTING LLC
Entity Type:Organization
Organization Name:DESTEFANO CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTEFANO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:406-647-0668
Mailing Address - Street 1:1780 SHILOH RD STE B
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1736
Mailing Address - Country:US
Mailing Address - Phone:307-299-9431
Mailing Address - Fax:406-656-1713
Practice Address - Street 1:1780 SHILOH RD STE B
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-1736
Practice Address - Country:US
Practice Address - Phone:406-647-0668
Practice Address - Fax:406-656-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366115123OtherTYPE I NPI