Individual
CARISSA KOSTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 FOWLER LN, PORTAGE, PA 15946-7112
(814) 736-9890
Mailing address
130 FOWLER LN, PORTAGE, PA 15946-7112
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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