Individual
ATHANASIA KOSTAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, DMIN
Contact information
Practice address
PO BOX 120, NEW LONDON, CT 06320-0120
(617) 665-1185
Mailing address
PO BOX 120, NEW LONDON, CT 06320-0120
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10167
CT
Other
Enumeration date
07/18/2012
Last updated
08/28/2024
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