Provider Demographics
NPI:1629568290
Name:BORRELLI, RAIN ARMATHA (BCBA)
Entity type:Individual
Prefix:
First Name:RAIN
Middle Name:ARMATHA
Last Name:BORRELLI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:BORRELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7025 HARBOR VIEW BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435
Mailing Address - Country:US
Mailing Address - Phone:757-656-1881
Mailing Address - Fax:
Practice Address - Street 1:7025 HARBOR VIEW BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435
Practice Address - Country:US
Practice Address - Phone:757-656-1881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-24-73249103K00000X
VA0133003769103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst