Provider Demographics
NPI:1780489328
Name:COSTA, TAYLA ALDEA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAYLA
Middle Name:ALDEA
Last Name:COSTA
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEA BREEZE DR APT D
Mailing Address - Street 2:
Mailing Address - City:SOUTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-3072
Mailing Address - Country:US
Mailing Address - Phone:774-330-8131
Mailing Address - Fax:
Practice Address - Street 1:85 SEA BREEZE DR APT D
Practice Address - Street 2:
Practice Address - City:SOUTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-3072
Practice Address - Country:US
Practice Address - Phone:774-330-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist