Provider Demographics
NPI:1972809333
Name:BORJA, LAUREN JACOBSON (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JACOBSON
Last Name:BORJA
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 1:113 S PEMBERTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1011
Mailing Address - Country:US
Mailing Address - Phone:973-452-1569
Mailing Address - Fax:
Practice Address - Street 1:113 S PEMBERTON AVE
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1011
Practice Address - Country:US
Practice Address - Phone:732-544-1529
Practice Address - Fax:732-544-1529
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00318600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist