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Individual

MARY KOSTIUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MCD, CCC-SLP

Contact information

Practice address
46 HOLLY DR, MEDFORD, NJ 08055-8844
(856) 912-8885
Mailing address
46 HOLLY DR, MEDFORD, NJ 08055-8844
(856) 912-8885

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01102800
NJ

Other

Enumeration date
04/03/2023
Last updated
04/03/2023
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