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1265583355
CHARLES T COSTA
DENVILLE, NJ
NPI
1265583355
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SC00842500)
Enumeration Date
2007-01-15
Last Update Date
2007-07-08
Business Address
-- CHARLES T COSTA LCSW
50 MORRIS AVE ST CLARE'S BEHAVIORAL HEALTH
DENVILLE, NJ 07834-1735
Phone number: 973-625-7009
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Mailing Address
-- CHARLES T COSTA LCSW
1101 RIVER RD
NEW MILFORD, NJ 07646-3222
Phone number: 201-836-0978
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