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1710668652
MARK ANTHONY COSTA
STOCKTON, CA
NPI
1710668652
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 9533)
Enumeration Date
2023-07-25
Last Update Date
2023-07-25
Business Address
MARK ANTHONY COSTA Certified Counselor
1105 N EL DORADO ST
STOCKTON, CA 95202-1305
Phone number: 209-938-0228
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Mailing Address
MARK ANTHONY COSTA Certified Counselor
1105 N EL DORADO ST
STOCKTON, CA 95202-1305
Phone number: 209-938-0228
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