JORDAN DANIEL COSTELLO

MARYVILLE, TN
NPI1942085238
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Additional Taxonomies1041C0700X Social Worker, Clinical
Enumeration Date2023-08-28
Last Update Date2024-05-15
Business Address
Mr. JORDAN DANIEL COSTELLO
1704 E BROADWAY AVE
MARYVILLE, TN 37804-2916
Phone number: 865-681-6990
Mailing Address
Mr. JORDAN DANIEL COSTELLO
200 TECH CENTER DR
KNOXVILLE, TN 37912-2747
Phone number:
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