Individual
CORTNEY ANN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
1525 E REPUBLIC RD, SPRINGFIELD, MO 65804-6527
(417) 831-9800
Mailing address
205 E GEORGIA ST, OZARK, MO 65721-8698
(417) 689-0661
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2012004105
MO
101YP2500X
Professional Counselor
7204
SD
Other
Enumeration date
01/24/2012
Last updated
01/04/2018
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