Individual
CHAD COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
506 W JACKMAN ST, LANCASTER, CA 93534-2531
(661) 726-2850
Mailing address
506 W JACKMAN ST, LANCASTER, CA 93534-2531
(661) 726-2850
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
64757
CA
1041C0700X
Clinical Social Worker
64757
CA
Other
Enumeration date
10/23/2020
Last updated
10/26/2020
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