Provider Demographics
NPI:1750821054
Name:COLBURN, CHRISTINE ANDREA (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANDREA
Last Name:COLBURN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-3611
Mailing Address - Country:US
Mailing Address - Phone:603-543-4200
Mailing Address - Fax:603-543-4244
Practice Address - Street 1:210 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2832
Practice Address - Country:US
Practice Address - Phone:603-543-4270
Practice Address - Fax:603-543-4235
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1275211041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool