Individual
TANEIA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
201 JASTRAM ST, PROVIDENCE, RI 02908-2708
(401) 854-6147
Mailing address
201 JASTRAM ST, PROVIDENCE, RI 02908-2708
(401) 854-6147
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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