Individual
ROSALIA COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4910 MUELLER BLVD STE 300, AUSTIN, TX 78723-3079
(312) 860-2140
Mailing address
4910 MUELLER BLVD STE 300, AUSTIN, TX 78723-3079
(312) 860-2140
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
39319
TX
174400000X
Specialist
C23472088864
IL
Other
Enumeration date
05/03/2012
Last updated
07/12/2023
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