Provider Demographics
NPI:1730209354
Name:BORGMANN, KIMBERLY J (MA,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:J
Last Name:BORGMANN
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:ALBURTIS
Mailing Address - State:PA
Mailing Address - Zip Code:18011-9594
Mailing Address - Country:US
Mailing Address - Phone:610-308-3299
Mailing Address - Fax:
Practice Address - Street 1:302 MAPLE CT
Practice Address - Street 2:
Practice Address - City:ALBURTIS
Practice Address - State:PA
Practice Address - Zip Code:18011-9594
Practice Address - Country:US
Practice Address - Phone:610-308-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019346660001Medicaid