Individual
WIDALYS BORGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91 FLEMING DR, INDEPENDENCE, KY 41051-8509
(513) 550-7820
Mailing address
91 FLEMING DR, INDEPENDENCE, KY 41051-8509
(513) 550-7820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11490
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11490
—
OH
Enumeration date
09/11/2015
Last updated
09/11/2015
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