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1700180361
JOHANNA COSTELLO
PORTLAND, ME
NPI
1700180361
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: ME ST2024)
Enumeration Date
2010-12-22
Last Update Date
2010-12-22
Business Address
-- JOHANNA COSTELLO
197 PINE ST APT 24
PORTLAND, ME 04102-3533
Phone number: 516-319-3889
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Mailing Address
-- JOHANNA COSTELLO
197 PINE ST APT 24
PORTLAND, ME 04102-3533
Phone number:
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