Individual
MS. MISCAH BORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 427-0193
Mailing address
6049 BROADWAY, MERRILLVILLE, IN 46410
(219) 427-0193
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
IN
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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