Individual
MR. DEMETRIOS NICOLAS KOSTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
185 CENTER STREET, SUITE B, WALLINGFORD, CT 06492
(203) 265-4580
Mailing address
193 POND HILL ROAD, WALLINGFORD, CT 06492
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005822
CT
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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