Individual
JAMIE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SWT
Contact information
Practice address
2000 NOBLE DR, WOOSTER, OH 44691-5353
(330) 264-3232
Mailing address
2000 NOBLE DR, WOOSTER, OH 44691-5353
(330) 264-3232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2403384-TRNE
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2847147
—
OH
Enumeration date
04/03/2018
Last updated
01/25/2024
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