Individual
SHELBEY ALLYN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
736 MAIN ST, BOONVILLE, MO 65233-1656
(660) 882-7474
Mailing address
4 BROADWAY VILLAGE DR APT H, COLUMBIA, MO 65201-8674
(417) 389-2751
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2019027108
MO
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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