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Individual

TINA MARIE BORKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
719 WEST FRONT ST., TYLER, TX 75702
(660) 864-6295
Mailing address
719 WEST FRONT ST., TYLER, TX 75702
(660) 864-6295

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
34882
TX
103TC0700X
Clinical Psychologist
Primary
34882
TX

Other

Enumeration date
03/28/2012
Last updated
09/18/2017
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