Doctor Name: | ILA LINDSEY BORCHARDT |
NPI Number: | 1952709248 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 24882 |
Business Practice Address: | 721 Dunaway Ln Azle, TX - 760202605 |
Business Phone Number: | 8174442536 |
Business Fax Number: | |
Mailing Address: | 3940 Wosley Dr, FORT WORTH |
State: | TX |
Postal Code: | 761332628 |
Phone Number: | 2148088746 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2014 |
NPI Last Update Date: | 12/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 24882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |