Provider Demographics
NPI:1790852408
Name:BORLAND, JILL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:BORLAND
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 W WACO DR
Mailing Address - Street 2:SUITE M
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-6306
Mailing Address - Country:US
Mailing Address - Phone:254-772-8055
Mailing Address - Fax:254-772-3019
Practice Address - Street 1:6001 W WACO DR
Practice Address - Street 2:SUITE M
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6306
Practice Address - Country:US
Practice Address - Phone:254-772-8055
Practice Address - Fax:254-772-3019
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health