MEDICARE: JENNIFER LEIGH BORDERS

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
1	101Y00000X	Counselor	99143	TX

General Provider Information

NPI Number	:	1578448544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEIGH BORDERS

Provider Business Mailing Address
First Line	:	3112 COLLEGE AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-4065
Country	:	US
Telephone Number	:	512-566-9463
Fax Number	:

Provider Business Practice Location Address
First Line	:	7550 FM 1187 W
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76126-5109
Country	:	US
Telephone Number	:	817-771-3236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2025
Last Update Date	:	08/08/2025

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Directions to “ JENNIFER LEIGH BORDERS ” Practice Location

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