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Individual

JENNIFER COSTELLO

Active
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Individual

JENNIFER COSTELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, RD

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149020773
IL
1041C0700X
Clinical Social Worker
CW018565
PA
1041C0700X
Clinical Social Worker
L6842
OR
133V00000X
Registered Dietitian
LDD10176233
OR

Other

Enumeration date
03/20/2014
Last updated
07/21/2022
About Stedi
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