Provider Demographics
NPI:1528543899
Name:DOMBROWSKI, RAEANN MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:RAEANN
Middle Name:MARIE
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PATMAR DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1531
Mailing Address - Country:US
Mailing Address - Phone:203-673-4591
Mailing Address - Fax:
Practice Address - Street 1:4 GEORGE ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7739
Practice Address - Country:US
Practice Address - Phone:203-673-4591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0094551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical