Provider Demographics
NPI:1679842959
Name:HENDERSON-BORGES, VERONICA L (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:L
Last Name:HENDERSON-BORGES
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3721
Mailing Address - Country:US
Mailing Address - Phone:707-253-4711
Mailing Address - Fax:
Practice Address - Street 1:2261 ELM ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3721
Practice Address - Country:US
Practice Address - Phone:707-253-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor