Provider Demographics
NPI:1588007066
Name:BORGMAN, TANESHA D (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TANESHA
Middle Name:D
Last Name:BORGMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:TANESHA
Other - Middle Name:D
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:550 LAVASTONE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-5896
Mailing Address - Country:US
Mailing Address - Phone:303-775-5772
Mailing Address - Fax:
Practice Address - Street 1:6801 W 20TH ST UNIT 212
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-9640
Practice Address - Country:US
Practice Address - Phone:970-301-4206
Practice Address - Fax:970-330-3954
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist