Provider Demographics
NPI:1679819403
Name:BORZA, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BORZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 S GOVERNORS AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4800
Mailing Address - Country:US
Mailing Address - Phone:302-674-3350
Mailing Address - Fax:
Practice Address - Street 1:1326 S GOVERNORS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4800
Practice Address - Country:US
Practice Address - Phone:302-674-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO4-0000346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist