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1275007767
MICHELLE ALYSE COSTELLO
CHICAGO, IL
NPI
1275007767
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.020672)
Enumeration Date
2019-01-17
Last Update Date
2021-10-22
Business Address
MICHELLE ALYSE COSTELLO LCSW
5215 N RAVENSWOOD AVE STE 214
CHICAGO, IL 60640-1670
Phone number: 312-476-9722
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Mailing Address
MICHELLE ALYSE COSTELLO LCSW
615 HINMAN AVE APT 3D
EVANSTON, IL 60202-3047
Phone number: 312-593-3553
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