Individual
MS. LORI MARIE BORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
705 S MAIN ST, SUITE 280, PLYMOUTH, MI 48170-2089
(734) 454-3560
Mailing address
23405 W. LE BOST, NOVI, MI 48375
(313) 283-3112
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
L1846640
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N65400
HAP PIN
MI
01
—
10408
BCBSM PIN
MI
Enumeration date
12/05/2011
Last updated
12/05/2011
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