Provider Demographics
NPI:1588431647
Name:BORDEN, KIMBERLEY L
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:L
Last Name:BORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FENN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6279
Mailing Address - Country:US
Mailing Address - Phone:413-443-7138
Mailing Address - Fax:413-443-8137
Practice Address - Street 1:1 FENN ST STE 4
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6279
Practice Address - Country:US
Practice Address - Phone:413-443-7138
Practice Address - Fax:413-443-8137
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician