Individual
SHELAGH COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3 GLEN DR, CASCO, ME 04015-3833
(800) 995-2673
(888) 979-6551
Mailing address
3 GLEN DR, CASCO, ME 04015-3833
(800) 995-2673
(888) 979-6551
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11007
MA
225X00000X
Occupational Therapist
OT01406
RI
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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