Provider Demographics
NPI:1275397986
Name:BORNEMANN, ADRIENNE D (LCAT, MS, MT-BC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:D
Last Name:BORNEMANN
Suffix:
Gender:F
Credentials:LCAT, MS, MT-BC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:308 SHERRILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SHERRILL
Mailing Address - State:NY
Mailing Address - Zip Code:13461-1222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:308 SHERRILL RD STE 100
Practice Address - Street 2:
Practice Address - City:SHERRILL
Practice Address - State:NY
Practice Address - Zip Code:13461-1222
Practice Address - Country:US
Practice Address - Phone:315-363-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY009957225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist