Doctor Name: | MS. KATELYN MARIE COSTELLO |
NPI Number: | 1831447911 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CF |
License Number: | |
Business Practice Address: | 2781 Osborn Dr Lake Havasu City, AZ - 864068629 |
Business Phone Number: | 9285055552 |
Business Fax Number: | |
Mailing Address: | 23 Valley Rd, LEVITTOWN |
State: | NY |
Postal Code: | 117562906 |
Phone Number: | 5167321755 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2012 |
NPI Last Update Date: | 08/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |