Individual
MARY KOELLING BORNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
1475 MAIN ST, WINDSOR, CO 80550-6029
(970) 449-5541
Mailing address
1915 13TH AVE, GREELEY, CO 80631-5446
(678) 357-8172
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003029
CO
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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