Individual
SHANNON MARIE COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CD(DONA)
Contact information
Practice address
4109 N WASHINGTON ST, WESTMONT, IL 60559-1334
(530) 360-9758
Mailing address
4109 N WASHINGTON ST, WESTMONT, IL 60559-1334
(530) 360-9758
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
15076
IL
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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