DANIEL RAY COSTELLO

SALEM, OR
NPI1215257720
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  08-08-10)
Enumeration Date2010-06-07
Last Update Date2010-06-07
Business Address
-- DANIEL RAY COSTELLO CADC 1
3180 CENTER ST NE DRUG TREATMENT
SALEM, OR 97301-4592
Phone number: 503-576-4660
Mailing Address
-- DANIEL RAY COSTELLO CADC 1
1641 D ST NE
SALEM, OR 97301-2664
Phone number: 503-910-4531
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