Organization
CANYON TREE PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN M BOMBERG LCSW (OWNER/PRACTICTIONER)
(720) 442-4506
Entity
Organization
Contact information
Practice address
9351 GRANT ST, 480, THORNTON, CO 80229-4358
(720) 442-4506
Mailing address
11829 RIDGE PKWY, 632, BROOMFIELD, CO 80021-5079
(720) 442-4506
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
993043
CO
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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