Individual
MS. KATELYN MARIE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CF
Contact information
Practice address
2781 OSBORN DR, LAKE HAVASU CITY, AZ 86406-8629
(928) 505-5552
Mailing address
23 VALLEY RD, LEVITTOWN, NY 11756-2906
(516) 732-1755
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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