Individual
MS. AILEEN BEAUCHAMP COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
150 RIDGE PIKE, #B-10, LAFAYETTE HILL, PA 19444-1929
(617) 645-7406
Mailing address
150 RIDGE PIKE, #B-10, LAFAYETTE HILL, PA 19444-1929
(617) 645-7406
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW126953
PA
Other
Enumeration date
11/23/2008
Last updated
11/23/2008
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