Individual
MRS. LISA COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5 MIDDLESEX AVE, SOMERVILLE, MA 02145-1102
(617) 591-4601
Mailing address
5 MIDDLESEX AVE, SOMERVILLE, MA 02145-1102
(617) 591-4601
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8968
MA
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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