Individual
JOHN M COSTELLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
9 HOPE AVE, WALTHAM, MA 02453-2741
(781) 216-2220
Mailing address
51 CHILTON RD, WEST ROXBURY, MA 02132-1717
(617) 325-1319
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2970
MA
Other
Enumeration date
01/25/2006
Last updated
07/08/2007
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