| Doctor Name: | VIVIAN C COSTA |
| NPI Number: | 1043361553 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1777 |
| Business Practice Address: | 627 Deer Acres Dr Goldsboro, NC - 275309238 |
| Business Phone Number: | 9197346649 |
| Business Fax Number: | 9197346649 |
| Mailing Address: | 476 Nahunta Rd Nw, PIKEVILLE |
| State: | NC |
| Postal Code: | 278638651 |
| Phone Number: | 9197352101 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 1777 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |