Basic Information
| Provider Information | |||||||||
| NPI: | 1497961049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VORBACH | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1104 E COLLEGE DR | ||||||||
| Address2: | STE B | ||||||||
| City: | MARSHALL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562584270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073372923 | ||||||||
| FaxNumber: | 5073372926 | ||||||||
| Practice Location | |||||||||
| Address1: | 1104 E COLLEGE DR | ||||||||
| Address2: | STE B | ||||||||
| City: | MARSHALL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562584270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073372923 | ||||||||
| FaxNumber: | 5073372926 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2007 | ||||||||
| LastUpdateDate: | 04/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LP4782 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.