Individual
ANA M COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
416 MAIN ST, MELROSE, MA 02176-3842
(781) 864-7729
Mailing address
31 LAKE SHORE RD, LYNN, MA 01904-1864
(781) 864-7729
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113616
MA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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