Healthcare Provider Details

I. General information

NPI: 1053238998
Provider Name (Legal Business Name): JAIDEN VERA BORUFF RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S DIXON RD STE 350
KOKOMO IN
46902-6430
US

IV. Provider business mailing address

2241 W JEFFERSON ST APT D238
KOKOMO IN
46901-4144
US

V. Phone/Fax

Practice location:
  • Phone: 765-789-0564
  • Fax:
Mailing address:
  • Phone: 765-631-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: