Individual
MR. CARL EDISON BORDERS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP/L
Contact information
Practice address
1724 SPEYER LN, REDONDO BEACH, CA 90278-4730
(310) 971-7416
Mailing address
1724 SPEYER LN, REDONDO BEACH, CA 90278-4730
(310) 971-7416
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP11420
CA
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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