Provider Demographics
NPI:1679559074
Name:BORCIC, DAGMAR (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:DAGMAR
Middle Name:
Last Name:BORCIC
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25208
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80936-5208
Mailing Address - Country:US
Mailing Address - Phone:719-660-4564
Mailing Address - Fax:303-400-1227
Practice Address - Street 1:25521 E SMOKY HILL RD UNIT 220
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1346
Practice Address - Country:US
Practice Address - Phone:303-400-2988
Practice Address - Fax:303-400-1227
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO305231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
804334Medicare PIN