Individual
MELISSA ANN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDP
Contact information
Practice address
105 BACON ST, PAWTUCKET, RI 02860-5542
(401) 871-8135
(401) 364-1982
Mailing address
105 BACON ST, PAWTUCKET, RI 02860-5542
(401) 871-8135
(401) 364-1982
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00836
RI
Other
Enumeration date
07/16/2020
Last updated
01/04/2024
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