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General NPI Number Information
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NPI Number | 1851177067
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Entity Type | Individual
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Provider Name | MS. KEESHA L BORDEN
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Gender | Female
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 05/16/2024
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Provider Practice Location Address
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Address Line | 420 W BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23220-4221
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Country | US
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Telephone | 804-252-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 6903 ALDER GROVE DR
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City | HENRICO
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State | VA
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Zip | 23228-2663
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Country | US
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Telephone | 804-252-5211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 8049
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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