Individual
MS. MARY COSTELLO LASCALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 SAGE RD, SUITE 201, CHAPEL HILL, NC 27514-6995
(919) 942-4166
(919) 942-8693
Mailing address
205 SAGE RD, SUITE 201, CHAPEL HILL, NC 27514-6995
(919) 942-4166
(919) 942-8693
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
677
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136AH
BLUE CROSS BLUE SHIELD
NC
Enumeration date
07/27/2006
Last updated
07/08/2007
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