Provider Demographics
NPI:1639559271
Name:TOWBIN, MARYANN (LMFT)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:TOWBIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MIA
Other - Middle Name:
Other - Last Name:TOWBIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:305 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4248
Mailing Address - Country:US
Mailing Address - Phone:970-663-3500
Mailing Address - Fax:970-292-1085
Practice Address - Street 1:305 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4248
Practice Address - Country:US
Practice Address - Phone:970-663-3500
Practice Address - Fax:970-292-1085
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist