Provider Demographics
NPI:1831361195
Name:BORDERS, ALEXANDRA R (AUD)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:R
Last Name:BORDERS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:R
Other - Last Name:VETROVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1528 NORTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1255
Mailing Address - Country:US
Mailing Address - Phone:320-252-0233
Mailing Address - Fax:320-257-1126
Practice Address - Street 1:1528 NORTHWAY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1255
Practice Address - Country:US
Practice Address - Phone:320-252-0233
Practice Address - Fax:320-257-1126
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist