| NPI | 1750894424 |
|---|---|
| Former Name | CATHERINE MARY COSTELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 521969) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2019-04-19 |