Individual
MS. SUMMER COSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1936 ALBANY POST RD, WALLKILL, NY 12589-3507
(845) 674-7832
Mailing address
1936 ALBANY POST RD, WALLKILL, NY 12589-3507
(845) 674-7832
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1857128
NY
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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