Provider Demographics
NPI:1689094161
Name:BORRELL, NATALIE (EDS)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BORRELL
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 SHANKLAND RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-5637
Mailing Address - Country:US
Mailing Address - Phone:440-975-3637
Mailing Address - Fax:
Practice Address - Street 1:5000 SHANKLAND RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-5637
Practice Address - Country:US
Practice Address - Phone:440-975-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3022006103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool