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General NPI Number Information
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NPI Number | 1215737374
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Entity Type | Individual
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Provider Name | TERESA COSTELLO
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Gender |
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1312 SPRING CREEK RD
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3918
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Country | US
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Telephone | 877-358-2998
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Fax | 423-405-6346
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Provider Business Mailing Address
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Address Line | 6784 CROOKED COVE WAY
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City | OOLTEWAH
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State | TN
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Zip | 37363-5500
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Country | US
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Telephone | 877-358-2998
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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