Individual
ANNE ELIZABETH COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801092595
MI
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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