Individual
TAMARA SUE COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
541 BART BULL RD, MIDDLETOWN, NY 10941-3917
(845) 978-1546
Mailing address
541 BART BULL RD, MIDDLETOWN, NY 10941-3917
(845) 978-1546
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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