Doctor Name: | MS. ELIZABETH M COSTELLO |
NPI Number: | 1073644738 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0000125-SLP |
Business Practice Address: | 604 W Washington St Bradford, PA - 167012646 |
Business Phone Number: | 8143684545 |
Business Fax Number: | 8143684379 |
Mailing Address: | 604 W Washington St, BRADFORD |
State: | PA |
Postal Code: | 167012646 |
Phone Number: | 8143684545 |
Fax Number: | 8143684379 |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0000125-SLP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |