Provider Demographics
NPI:1508083254
Name:BORLAND HUNT, DOLORES M (PHD)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:M
Last Name:BORLAND HUNT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10279 SOUTH BAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848
Mailing Address - Country:US
Mailing Address - Phone:517-651-6606
Mailing Address - Fax:
Practice Address - Street 1:10279 SOUTH BAY DRIVE
Practice Address - Street 2:
Practice Address - City:LAINGSBURG
Practice Address - State:MI
Practice Address - Zip Code:48848
Practice Address - Country:US
Practice Address - Phone:517-651-6606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILPC6401007347101YP2500X
MILMFT4101005238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist