| NPI | 1174254619 |
|---|---|
| Former Name | MADALYN MARIE KOSTUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C018606) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P017676) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-07-22 |