Individual
ALEXIS BORODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 MAPLE AVE, LOVES PARK, IL 61111-3006
(815) 654-4502
Mailing address
6389 GREEN NEEDLE DR, LOVES PARK, IL 61111-7119
(724) 219-5722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013480
IL
Other
Enumeration date
05/09/2018
Last updated
08/27/2024
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