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1043042690
TARA MARIE COSTELLO
FARMINGTON, CT
NPI
1043042690
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-08-14
Last Update Date
2024-08-14
Business Address
TARA MARIE COSTELLO
304 MAIN ST STE A
FARMINGTON, CT 06032-2985
Phone number: 845-490-7830
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Mailing Address
TARA MARIE COSTELLO
1466 CHRISTINE RD
MOHEGAN LAKE, NY 10547-1761
Phone number: 845-490-7830
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