Individual
MATTIE COSTILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCMH
Contact information
Practice address
17021 OLD ORCHARD RD, LEWES, DE 19958-4832
(302) 703-6332
Mailing address
782 HILL AVE, ASTON, PA 19014-1110
(610) 675-6380
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC-0000714
DE
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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