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NPI Code Detail

MEDICARE: DR. VALERIE JEANNETTE BORJA PHD, CRC, LPC

MEDICARE: DR. VALERIE JEANNETTE BORJA PHD, CRC, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor65114
2101YP2500XProfessional Counselor65114TX

General Provider Information

NPI Number : 1114566262
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VALERIE JEANNETTE BORJA PHD, CRC, LPC
Provider Business Mailing Address
First Line : 1424 SUMMIT AVE APT 3020
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-5980
Country : US
Telephone Number : 956-776-8257
Fax Number :
Provider Business Practice Location Address
First Line : 1424 SUMMIT AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76102-5906
Country : US
Telephone Number : 956-776-8257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2020
Last Update Date : 01/06/2020

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