Individual
JESSICA LYNNE BORELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 W INTERSTATE 240 SERVICE RD, OKLAHOMA CITY, OK 73139-7701
(405) 604-9644
Mailing address
721 VICKSBURG AVE, APT F, NORMAN, OK 73071-2244
(405) 426-5597
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
T08360240
OK
Other
Enumeration date
04/29/2016
Last updated
01/23/2017
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