Provider Demographics
NPI:1497961049
Name:VORBACH, ANNE MARIE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:VORBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 E COLLEGE DR
Mailing Address - Street 2:STE B
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-4270
Mailing Address - Country:US
Mailing Address - Phone:507-337-2923
Mailing Address - Fax:507-337-2926
Practice Address - Street 1:1104 E COLLEGE DR
Practice Address - Street 2:STE B
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-4270
Practice Address - Country:US
Practice Address - Phone:507-337-2923
Practice Address - Fax:507-337-2926
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4782103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical