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Individual

MR. PATRICK COSTELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW,LCSW

Contact information

Practice address
9911 ARABIAN DR, BOISE, ID 83709
(208) 870-6460
(208) 395-1948
Mailing address
9911 ARABIAN DR, BOISE, ID 83709
(208) 362-5622

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW474
ID

Other

Enumeration date
08/15/2006
Last updated
04/08/2011
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