Provider Demographics
NPI:1427207901
Name:TRISH BORMAN PHD PLLC
Entity Type:Organization
Organization Name:TRISH BORMAN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-489-8383
Mailing Address - Street 1:14679 MIDWAY RD STE 224
Mailing Address - Street 2:STE 306 #277
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3927
Mailing Address - Country:US
Mailing Address - Phone:972-489-8383
Mailing Address - Fax:
Practice Address - Street 1:14679 MIDWAY RD STE 224
Practice Address - Street 2:STE 306 #277
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3927
Practice Address - Country:US
Practice Address - Phone:972-489-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty