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General NPI Number Information
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NPI Number | 1942775242
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Entity Type | Individual
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Provider Name | ALEXANDRIA KOUTSOKOSTAS MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 2425 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-3358
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Country | US
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Telephone | 415-833-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 910 WALNUT AVE APT 307
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City | CHARLOTTE
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State | NC
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Zip | 28208-4674
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Country | US
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Telephone |
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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 |
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License Number State |
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