Provider Demographics
NPI:1528382454
Name:BORRELLI, BRIDGET (BCBA)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:BORRELLI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15255 S 94TH AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3800
Mailing Address - Country:US
Mailing Address - Phone:312-342-0631
Mailing Address - Fax:815-806-7439
Practice Address - Street 1:15255 S 94TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3800
Practice Address - Country:US
Practice Address - Phone:312-342-0631
Practice Address - Fax:815-806-7439
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst