Provider Demographics
NPI:1265560791
Name:BORSHEIM, HARRY (LLP)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:BORSHEIM
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7375
Mailing Address - Country:US
Mailing Address - Phone:269-979-8333
Mailing Address - Fax:269-979-7766
Practice Address - Street 1:3630 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7375
Practice Address - Country:US
Practice Address - Phone:269-979-8333
Practice Address - Fax:269-979-7766
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008927103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral