Individual
MS. DANA M COSTAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3355 MISSION AVE STE 123, OCEANSIDE, CA 92058-1327
(760) 529-4975
Mailing address
6973 BLUE ORCHID LN, CARLSBAD, CA 92011-5164
(650) 275-3931
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 23356
CA
Other
Enumeration date
09/16/2014
Last updated
03/01/2016
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