Individual
KATHLEEN M COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
14953 S VAN DYKE RD, PLAINFIELD, IL 60544-5804
(815) 609-1544
(815) 609-1670
Mailing address
14953 S VAN DYKE RD, PLAINFIELD, IL 60544-5804
(815) 609-1544
(815) 609-1670
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007889
IL
Other
Enumeration date
05/25/2012
Last updated
06/17/2021
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