Individual
ANNIE CECELY DORNBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2505 23RD ST, BOULDER, CO 80304
(415) 730-3991
Mailing address
2505 23RD ST, BOULDER, CO 80304-3705
(415) 730-3991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09924864
CO
1041C0700X
Clinical Social Worker
27422
CA
Other
Enumeration date
08/30/2007
Last updated
08/15/2018
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