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NPI Code Detail

MEDICARE: MARINA BORRERO BOBADILLA LPC

MEDICARE:   MARINA  BORRERO BOBADILLA  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178019184IL

General Provider Information

NPI Number : 1215617881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARINA BORRERO BOBADILLA LPC
Provider Business Mailing Address
First Line : 169 S SPRINGSIDE DR
Second Line :
City : ROUND LAKE
State : IL
Zip : 60073-9620
Country : US
Telephone Number : 847-828-8661
Fax Number :
Provider Business Practice Location Address
First Line : 1860 W WINCHESTER RD STE 204
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-5317
Country : US
Telephone Number : 847-828-8661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2023
Last Update Date : 03/02/2024

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Directions to “ MARINA BORRERO BOBADILLA LPC” Practice Location

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