Provider Demographics
NPI:1417260639
Name:BORGES, ROSE (MA)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:BORGES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-5133
Mailing Address - Country:US
Mailing Address - Phone:508-224-7701
Mailing Address - Fax:508-224-2845
Practice Address - Street 1:1233 STATE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-5133
Practice Address - Country:US
Practice Address - Phone:508-224-7701
Practice Address - Fax:508-224-2845
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health