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1679307193
KELLY ANNE COSTELLO
DULUTH, GA
NPI
1679307193
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-08-27
Last Update Date
2024-08-27
Business Address
KELLY ANNE COSTELLO
3390 N BERKELEY LAKE RD NW STE 100
DULUTH, GA 30096-3006
Phone number: 470-327-8336
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Mailing Address
KELLY ANNE COSTELLO
511 AMBER STONE
WALESKA, GA 30183-4311
Phone number:
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