Individual
MS. LISA ELLIS COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
8B DAWSON RD, GREENVILLE, SC 29609-1310
(864) 246-3135
Mailing address
8B DAWSON RD, GREENVILLE, SC 29609-1310
(864) 246-3135
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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