Individual
BRIANA L COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
71 US ROUTE 1 STE C, SCARBOROUGH, ME 04074-7174
(207) 883-5532
(207) 883-5552
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3175
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC16511
ME
1041C0700X
Clinical Social Worker
Primary
LC17949
ME
Other
Enumeration date
08/27/2018
Last updated
05/18/2020
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