Individual
KRISTY COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1052
(651) 647-1900
Mailing address
2550 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1052
(651) 647-1900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC00964
MN
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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