Basic Information
Provider Information
NPI: 1801189774
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOROWIEC
FirstName: RACHEL
MiddleName: E
NamePrefix: MRS.
NameSuffix:  
Credential: MS, LAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NORLUND
OtherFirstName: RACHEL
OtherMiddleName: E
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 8220 CASTOR AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191522729
CountryCode: US
TelephoneNumber: 2153056674
FaxNumber:  
Practice Location
Address1: 8220 CASTOR AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191522729
CountryCode: US
TelephoneNumber: 2153056674
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/25/2011
LastUpdateDate: 02/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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