Provider Demographics
NPI:1316422306
Name:BOROWY, MADISON
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:
Last Name:BOROWY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 BERRY CREEK DR UNIT 205
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7528
Mailing Address - Country:US
Mailing Address - Phone:803-292-7343
Mailing Address - Fax:
Practice Address - Street 1:1150 HUNGRYNECK BLVD STE C342
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3484
Practice Address - Country:US
Practice Address - Phone:803-292-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist