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Individual
COLBY GANNON BACKMAN
Active
Individual
COLBY GANNON BACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9835346-6004
UT
Other
Enumeration date
09/09/2015
Last updated
04/19/2023
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