Individual
ALEXIS COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
89 PEMBROOK DR, KENILWORTH, NJ 07033-1435
(908) 937-4080
Mailing address
89 PEMBROOK DR, KENILWORTH, NJ 07033-1435
(908) 937-4080
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NJ
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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