Individual
JOHN COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW LADC I CADAC II
Contact information
Practice address
795 MIDDLE ST, FALL RIVER, MA 02721-1733
(150) 823-5010
(508) 235-5053
Mailing address
PO BOX 79354, NORTH DARTMOUTH, MA 02747-0984
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2107
MA
101Y00000X
Counselor
Primary
300569
MA
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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