Provider Demographics
NPI:1316103385
Name:ANDERSON-DOBROSKI, CYNTHIA L
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:ANDERSON-DOBROSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:L
Other - Last Name:DOBROSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LCPC
Mailing Address - Street 1:2701 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-5351
Mailing Address - Country:US
Mailing Address - Phone:309-779-3200
Mailing Address - Fax:309-779-2755
Practice Address - Street 1:4600 3RD ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6106
Practice Address - Country:US
Practice Address - Phone:309-779-2031
Practice Address - Fax:309-779-2917
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003170101YP2500X
IA083827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional