Doctor Name: | TRICIA SULLIVAN BORELLI |
NPI Number: | 1760443535 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 00342 |
Business Practice Address: | 2728 Asbury Rd Dubuque, IA - 520012971 |
Business Phone Number: | 5635569642 |
Business Fax Number: | |
Mailing Address: | 3340 David Dr, DUBUQUE |
State: | IA |
Postal Code: | 520022905 |
Phone Number: | 5632134259 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2006 |
NPI Last Update Date: | 11/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 00342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |