Provider Demographics
NPI:1821141045
Name:CABANILLA, ANNE SMITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:SMITH
Last Name:CABANILLA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 EAST ELKHORN AVENUE
Mailing Address - Street 2:PO BOX 3942
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517
Mailing Address - Country:US
Mailing Address - Phone:970-586-1090
Mailing Address - Fax:970-586-1091
Practice Address - Street 1:356 EAST ELKHORN AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517
Practice Address - Country:US
Practice Address - Phone:970-586-1090
Practice Address - Fax:970-586-1091
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3050103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist