Individual
ALICIA RENEE COSTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
1698 HWY 160 W., STE. 240, FORT MILL, SC 29708-2970
(704) 654-8599
Mailing address
13001 SEASCAPE LN, CHARLOTTE, NC 28278-7113
(704) 877-3191
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-19-9516
NC
106E00000X
Assistant Behavior Analyst
Primary
0-19-9516
—
Other
Enumeration date
11/27/2019
Last updated
02/10/2021
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