Individual
MS. DIA CLAIRE COSTELLO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6100 HARVARD AVE, GLEN ECHO, MD 20812-1116
(301) 263-9616
Mailing address
5402 CONNECTICUT AVE NW STE 102B, WASHINGTON, DC 20015-2857
(301) 538-7784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC302342
DC
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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