Provider Demographics
NPI:1689990855
Name:BORELLI, NANCY (SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BORELLI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 LAUREL CANYON BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1568
Mailing Address - Country:US
Mailing Address - Phone:818-760-0500
Mailing Address - Fax:818-763-3890
Practice Address - Street 1:6400 LAUREL CANYON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1568
Practice Address - Country:US
Practice Address - Phone:818-760-0500
Practice Address - Fax:818-763-3890
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP562235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist