Individual
MRS. MONIQUE COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9378 OLIVE BLVD, STE 317, SAINT LOUIS, MO 63132-3215
(314) 994-9344
Mailing address
9706 HALE DR, SAINT LOUIS, MO 63123-5523
(314) 808-7501
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2015002313
MO
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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