| NPI | 1184246597 | 
|---|---|
| Other Name | LAWRENCE A DEFIESTA | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10499-M) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P014490) | 
| Enumeration Date | 2020-05-08 | 
| Last Update Date | 2024-04-18 |