Provider Demographics
NPI:1285203737
Name:KALANJ, BORKA
Entity Type:Individual
Prefix:
First Name:BORKA
Middle Name:
Last Name:KALANJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S GARDENS WAY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7675
Mailing Address - Country:US
Mailing Address - Phone:608-320-9540
Mailing Address - Fax:
Practice Address - Street 1:1426 PALM GRASS PASS
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2374
Practice Address - Country:US
Practice Address - Phone:608-821-6356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health