| Doctor Name: | JENNIFER COSTELLO |
| NPI Number: | 1659798205 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | DN004882 |
| Business Practice Address: | 110 Fort Couch Rd Suite G200 Pittsburgh, PA - 152411030 |
| Business Phone Number: | 4123470170 |
| Business Fax Number: | 4123470174 |
| Mailing Address: | 110 Fort Couch Rd, Suite G200 PITTSBURGH |
| State: | PA |
| Postal Code: | 152411030 |
| Phone Number: | 4123470170 |
| Fax Number: | 4123470174 |
| NPI Enumeration Date: | 03/20/2014 |
| NPI Last Update Date: | 06/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DN004882 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |