Individual
MICHELE DIANA DELLA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
1415 37TH STREET CT W, BRADENTON, FL 34205-2268
(941) 504-3316
Mailing address
1415 37TH STREET CT W, BRADENTON, FL 34205-2268
(941) 504-3316
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT4389
FL
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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