Individual
CHRISTIAN COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
81 LAKE AVE, ROCHESTER, NY 14608-1410
(585) 368-6900
Mailing address
81 LAKE AVE, ROCHESTER, NY 14608-1410
(585) 368-6900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
061572
NY
Other
Enumeration date
08/13/2008
Last updated
08/26/2008
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