| NPI | 1013526318 |
|---|---|
| Other Name | NIKI COSTELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 14770) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OR 93-6002307) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: MO 1922) | |
| 261QM2800X Clinic/Center, Methadone Clinic (Licence: MO 14770) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 14770) | |
| 247000000X Technician, Health Information | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2026-01-07 |