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Individual

MS. JUDY G BOERSMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AUDIOLOGIST

Contact information

Practice address
173 SCHAN DR, CHURCHVILLE, PA 18966-1619
(215) 485-3205
Mailing address
173 SCHAN DR, CHURCHVILLE, PA 18966-1619
(215) 485-3205

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
AT000690L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2009007983
MO AUDIOLOGY LICENSE
MO
01
41YA00072600
NJ AUDIOLOGY LICENSE
NJ
01
AT000690L
PA AUDIOLOGY LICENSE
PA
Enumeration date
05/26/2010
Last updated
05/26/2010
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