Healthcare Provider Details

I. General information

NPI: 1487568630
Provider Name (Legal Business Name): ALLISON BORHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 DURBIN STATION CT STE 303
SAINT JOHNS FL
32259-9368
US

IV. Provider business mailing address

75 DURBIN STATION CT STE 303
SAINT JOHNS FL
32259-9368
US

V. Phone/Fax

Practice location:
  • Phone: 904-323-3056
  • Fax:
Mailing address:
  • Phone: 904-323-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26708
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: