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General NPI Number Information
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NPI Number | 1093835498
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Entity Type | Individual
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Provider Name | CAROL ROYER COSTELLO PH.D
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 800 N FIELDER RD
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City | ARLINGTON
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State | TX
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Zip | 76012-5899
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Country | US
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Telephone | 817-548-0300
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Fax | 817-795-9668
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Provider Business Mailing Address
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Address Line | 9321 MARBLE FALLS DR
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City | ARLINGTON
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State | TX
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Zip | 76002-3092
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Country | US
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Telephone | 817-473-6261
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Fax | 817-795-9668
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9886
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License Number State | TX
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