Individual
KYANA MARIE DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1121 N 44TH ST APT 4083, PHOENIX, AZ 85008-5748
(401) 524-9784
Mailing address
1121 N 44TH ST APT 4083, PHOENIX, AZ 85008-5748
(401) 524-9784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW03761
RI
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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