| NPI | 1730542382 |
|---|---|
| Former Name | NICOLE ANN COSTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 101251) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 101251) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2018-10-29 |