Provider Demographics
NPI:1154460210
Name:BORGER, LINDA A (SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:BORGER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64505-2211
Mailing Address - Country:US
Mailing Address - Phone:816-279-0190
Mailing Address - Fax:816-279-0190
Practice Address - Street 1:2220 N 22ND ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64505-2211
Practice Address - Country:US
Practice Address - Phone:816-279-0190
Practice Address - Fax:816-279-0190
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO117794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist