Provider Demographics
NPI:1518168111
Name:BORCHERS, LYNDA KAY (MA LP)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:KAY
Last Name:BORCHERS
Suffix:
Gender:F
Credentials:MA LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 78TH STREET EAST
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-2818
Mailing Address - Country:US
Mailing Address - Phone:651-387-7122
Mailing Address - Fax:
Practice Address - Street 1:2346 78TH STREET EAST
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-2818
Practice Address - Country:US
Practice Address - Phone:651-387-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3627103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN38Q05B0OtherBLUE CROSS BLUE SHIELD