Individual
KESHIA MARIE COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2708 NE 14TH ST, SUITE 5, POMPANO BEACH, FL 33062-3565
(188) 888-0927
Mailing address
31 DEVORE AVE, HAMPTON, VA 23666-5682
(757) 814-7378
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
T28431110
—
Other
Enumeration date
08/05/2012
Last updated
08/05/2012
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