Individual
MS. CANDICE DENISE COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 ELWYN RD, ELWYN, PA 19063-4622
(610) 891-2000
Mailing address
5827 THEODORE ST, PHILADELPHIA, PA 19143-6010
(215) 726-1509
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
PA
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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