| NPI | 1316281009 |
|---|---|
| Former Name | AMANDA COSTELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OH OT008370) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201008341) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2024-12-04 |