| NPI | 1255605242 |
|---|---|
| Other Name | ANN M COSTILOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 11051) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2015-04-09 |