| 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 |