| Doctor Name: | KATIE MELISSA BORN |
| NPI Number: | 1356659361 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. CCC-CLP |
| License Number: | 019674-01 |
| Business Practice Address: | 5225 Nesconset Hwy Building 7 Suite 41-42 Port Jefferson Station, NY - 117762053 |
| Business Phone Number: | 6314734284 |
| Business Fax Number: | |
| Mailing Address: | 305 E Broadway, PORT JEFFERSON |
| State: | NY |
| Postal Code: | 117771251 |
| Phone Number: | 6316723165 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2010 |
| NPI Last Update Date: | 09/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 019674-01 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |