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Individual

DIANE COSTULAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
7301 W PALMETTO PARK RD STE 106B, BOCA RATON, FL 33433-3455
(561) 571-7557
Mailing address
10517 SANTA LAGUNA DR, BOCA RATON, FL 33428-1208
(570) 295-3579

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC010843
PA
225X00000X
Occupational Therapist
Primary
OT21478
FL

Other

Enumeration date
06/30/2010
Last updated
09/22/2021
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