Individual
JESSICA MARIE COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
2525 W ANKLAM RD, #111, TUCSON, AZ 85745-1874
(614) 716-8637
Mailing address
2525 W ANKLAM RD, #111, TUCSON, AZ 85745-1874
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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