Individual provider · Type 1 NPI

Tiffany Costello

Developmental Therapist · East Peoria, IL

NPI number 1053715334 Active

Practice location

406 Dundee Rd
East Peoria, IL 61611-1614

Call (217) 414-4858 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1053715334

Tiffany Costello's National Provider Identifier is 1053715334, issued on Oct 15, 2014. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in East Peoria, IL. The record was last updated on Oct 15, 2014.