Individual
STEPHANIE JOHANNA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 WORTHINGTON DRIVE, EXTON, PA 19341
(484) 844-5354
Mailing address
85 OLD EAGLE SCHOOL RD, WAYNE, PA 19087-2556
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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