Provider Demographics
NPI:1609469410
Name:BORATYN, ANNA (LLMSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BORATYN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:FELIX
Other - Middle Name:
Other - Last Name:BORATYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:315 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1133
Mailing Address - Country:US
Mailing Address - Phone:734-821-0216
Mailing Address - Fax:734-821-0216
Practice Address - Street 1:315 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1133
Practice Address - Country:US
Practice Address - Phone:734-821-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical