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Individual

MS. ANN M COSTILOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
2626 CHARLES DR, CHALMETTE, LA 70043-3779
(504) 278-4006
Mailing address
2626 CHARLES DR, CHALMETTE, LA 70043-3779
(504) 278-4006

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
11051
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00018214
MS
Enumeration date
03/08/2012
Last updated
04/09/2015
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