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Individual

MR. MATT COSTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
2200 E CLEVELAND ST, MONETT, MO 65708-6149
(417) 236-2600
(417) 236-2619
Mailing address
2200 E CLEVELAND ST, MONETT, MO 65708-6149
(417) 236-2600
(417) 236-2619

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2010032191
MO

Other

Enumeration date
08/21/2008
Last updated
08/08/2016
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