Doctor Name: | LEE ANN HERZOG-BOROWIAK |
NPI Number: | 1275513764 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.S, LPC, NCC, NAMP |
License Number: | 000531 |
Business Practice Address: | 888 Ste Genevieve Dr Ste Genevieve, MO - 636701434 |
Business Phone Number: | 5738835384 |
Business Fax Number: | 5738837464 |
Mailing Address: | 888 Ste Genevieve Dr, STE GENEVIEVE |
State: | MO |
Postal Code: | 636701434 |
Phone Number: | 5738835384 |
Fax Number: | 5738837464 |
NPI Enumeration Date: | 01/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000531 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |