Individual
JESSICA ANNE COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
5086 LYNCH CT, CARLSBAD, CA 92008-3861
(619) 609-6287
Mailing address
5086 LYNCH CT, CARLSBAD, CA 92008-3861
(619) 609-6287
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12459
CA
Other
Enumeration date
06/23/2022
Last updated
03/06/2023
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