Individual
MRS. BRANDY COLEEN BORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 S CENTER DR # B, CLEARLAKE, CA 95422-8131
(707) 994-7090
Mailing address
PO BOX 1024, LUCERNE, CA 95458-1024
(707) 994-7090
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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