Individual
JESSICA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
10000 MIDATLANTIC DR STE 101E, MOUNT LAUREL, NJ 08054-1504
(732) 982-2888
Mailing address
501 DUBOIS AVE, BARRINGTON, NJ 08007-1013
(267) 902-4280
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00969700
NJ
101YP2500X
Professional Counselor
PC012728
PA
Other
Enumeration date
10/18/2023
Last updated
12/19/2024
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