Provider Demographics
NPI:1962521930
Name:HOLBOROW, BEVERLY A (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:A
Last Name:HOLBOROW
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 GEMINI CT
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-5317
Mailing Address - Country:US
Mailing Address - Phone:609-242-8060
Mailing Address - Fax:
Practice Address - Street 1:1212 GEMINI CT
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-5317
Practice Address - Country:US
Practice Address - Phone:609-242-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00257900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist