Individual
ALYSSE LYNETTE BORBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRMII, PSS, CRGM
Contact information
Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(971) 219-3314
Mailing address
1111 CRATER LAKE AVE, MEDFORD, OR 97504-6241
(971) 219-3314
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
23-CRM-II-0138
OR
Other
Enumeration date
01/14/2020
Last updated
09/19/2024
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