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NPI Code Detail

MEDICARE: MRS. ALEXANDRIA WILBURN COSTLOW

MEDICARE: MRS. ALEXANDRIA WILBURN COSTLOW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2025054164MO

General Provider Information

NPI Number : 1255843892
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALEXANDRIA WILBURN COSTLOW
Provider Business Mailing Address
First Line : 4400 DR MARTIN LUTHER KING JR BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-2870
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4400 DR MARTIN LUTHER KING JR BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-2870
Country : US
Telephone Number : 816-886-4052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 01/15/2026

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Directions to “ MRS. ALEXANDRIA WILBURN COSTLOW ” Practice Location

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