Provider Demographics
NPI:1790199404
Name:BORLAND, JOANN ALYCE (HEARING AID DISPENSE)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:ALYCE
Last Name:BORLAND
Suffix:
Gender:F
Credentials:HEARING AID DISPENSE
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2400 HIGHWAY 95
Mailing Address - Street 2:SUITE 50
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7313
Mailing Address - Country:US
Mailing Address - Phone:928-763-1973
Mailing Address - Fax:928-758-3301
Practice Address - Street 1:2400 HIGHWAY 95
Practice Address - Street 2:SUITE 50
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7313
Practice Address - Country:US
Practice Address - Phone:928-763-1973
Practice Address - Fax:928-758-3301
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZHAD1193237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist