Individual
YESENIA G COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
140 S BEACH ST STE 310, DAYTONA BEACH, FL 32114-4409
(407) 334-1369
Mailing address
140 S BEACH ST STE 310, DAYTONA BEACH, FL 32114-4409
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/11/2020
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