Provider Demographics
NPI:1811065543
Name:BORZELLINO, DEBRA ANN
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:BORZELLINO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:BORZELLINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:88 S COLMAN RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2856
Mailing Address - Country:US
Mailing Address - Phone:032-232-4462
Mailing Address - Fax:860-567-3357
Practice Address - Street 1:416 HIGHLAND AVE STE 7
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2531
Practice Address - Country:US
Practice Address - Phone:203-232-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001093106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist