Organization
BEVERLY A. COSTINEW PHD P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY A COSTINEW (OWNER)
(810) 923-8402
Entity
Organization
Contact information
Practice address
38345 W 10 MILE RD, SUITE 150, FARMINGTON HILLS, MI 48335-2867
(810) 923-8402
(810) 355-1337
Mailing address
38345 W 10 MILE RD, SUITE 150, FARMINGTON HILLS, MI 48335-2867
(810) 923-8402
(810) 355-1337
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620F34792
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/16/2007
Last updated
10/05/2010
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