Provider Demographics
NPI:1851697874
Name:BOREL, AMY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BOREL
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 1:3445 GEMSTONE DR
Mailing Address - Street 2:APT #516
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8173
Mailing Address - Country:US
Mailing Address - Phone:248-765-7081
Mailing Address - Fax:
Practice Address - Street 1:3445 GEMSTONE DR
Practice Address - Street 2:APT #516
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-8173
Practice Address - Country:US
Practice Address - Phone:248-765-7081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist