Individual
SHAUNA VIOLET COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
910 SEWARD ST RM 410, DETROIT, MI 48202
(248) 544-0360
Mailing address
910 SEWARD ST RM 410, DETROIT, MI 48202-2355
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19483
MI
Other
Enumeration date
10/12/2015
Last updated
08/29/2018
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