Tina Marie Borke
Psychologist, Clinical in Tyler, TX. Individual provider (NPI-1).
NPI number1144596792
StatusActive
Last updated in NPPESSep 18, 2017
Details
- NPI
- 1144596792
- Entity type
- Individual (NPI-1)
- Name
- Tina Marie Borke
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 28, 2012
- Last updated
- Sep 18, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 34882 | TX | Yes |
| 103G00000X | Clinical Neuropsychologist | 34882 | TX |
Practice location
719 West Front St.Tyler, TX 75702
Phone 660-864-6295
Mailing address
719 West Front St.Tyler, TX 75702
Phone 660-864-6295
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