Individual
MRS. TAMMY MARIE BORRELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
201 E GREEN ST STE 500, ITHACA, NY 14850-5635
(607) 274-6288
Mailing address
201 E GREEN ST STE 500, ITHACA, NY 14850-5635
(607) 274-6288
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18971
NY
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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