Tiffany Costello
NPI #1053715334 in East Peoria, Illinois
Provider Information
- NPI Number
- 1053715334
- Entity Type
- Individual
- Name
- Tiffany Costello
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Developmental Therapist
- Enumeration Date
- Oct 15, 2014
- Last Updated
- Oct 15, 2014
Practice Location
- Address
- 406 DUNDEE RD
- City
- East Peoria
- State
- Illinois
- ZIP Code
- 61611-1614
- Phone
- (217) 414-4858
Specialties & Taxonomy Codes
| Specialty |
|---|
| Developmental Therapist |
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