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General NPI Number Information
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NPI Number | 1508505462
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Entity Type | Individual
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Provider Name | MEGAN ELISE COSTO MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 106 E MARTINTOWN RD STE A
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3425
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Country | US
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Telephone | 803-993-9959
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Fax |
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Provider Business Mailing Address
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Address Line | 110 FOX TRAIL DR
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City | NORTH AUGUSTA
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State | SC
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Zip | 29860-9061
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Country | US
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Telephone | 678-491-5195
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8533
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | PCET003556
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License Number State | GA
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