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Individual

JULIA COSTELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
1698 HIGHWAY 160 W STE 240, FORT MILL, SC 29708-8035
(704) 654-8599
Mailing address
1698 HIGHWAY 160 W STE 240, FORT MILL, SC 29708-8035
(704) 654-8599
(336) 642-0384

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12308
NC
235Z00000X
Speech-Language Pathologist
Primary
5945
SC
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SA1639
SC
Enumeration date
02/11/2016
Last updated
07/30/2025
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