Individual
MS. GINA MARIE COSTI-WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 626-4444
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(858) 626-4447
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
24717
CA
Other
Enumeration date
11/25/2019
Last updated
02/05/2020
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