Provider Demographics
NPI:1104396365
Name:COSTA, BILLIE-JO (HIS)
Entity Type:Individual
Prefix:MISS
First Name:BILLIE-JO
Middle Name:
Last Name:COSTA
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 NW BURDETT XING
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-1610
Mailing Address - Country:US
Mailing Address - Phone:816-621-2400
Mailing Address - Fax:
Practice Address - Street 1:1765 NW BURDETT XING
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-1610
Practice Address - Country:US
Practice Address - Phone:816-621-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018015915237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist