Individual
DR. BRIAN DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
935 E CHOCOLATE AVE, HERSHEY, PA 17033-1216
(717) 462-7003
Mailing address
825 EDEN RD, LANCASTER, PA 17601-4713
(717) 462-7003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS020740
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2018
Last updated
05/20/2026
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