Individual
MRS. LISA BORELLI DESAUTELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
24 TABOR XING STE D34, LONGMEADOW, MA 01106-1785
(413) 567-7800
Mailing address
206 HAZARDVILLE RD, LONGMEADOW, MA 01106-3331
(413) 519-2295
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4263
MA
235Z00000X
Speech-Language Pathologist
4263
—
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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