Provider Demographics
NPI:1306739990
Name:COSTELLO-YACONO, MAUREEN (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:COSTELLO-YACONO
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GLENOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1992
Mailing Address - Country:US
Mailing Address - Phone:215-833-1339
Mailing Address - Fax:
Practice Address - Street 1:14 GLENOLDEN RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1992
Practice Address - Country:US
Practice Address - Phone:215-833-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008496235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist