Individual
COSTULA CASSIANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT-16-23564
Contact information
Practice address
20W438 CAMDER DRIVE, DOWNERS GROVE, IL 60516
(708) 825-4287
Mailing address
20W438 CAMDER DRIVE, DOWNERS GROVE, ID 60516
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16-23564
IL
Other
Enumeration date
06/02/2018
Last updated
06/02/2018
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