# KIMBERLEY ANNE BACKSTROM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447714647
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | ASW87254 | CA | — |
| 104100000X | Social Worker | 1358P-S | NV | Yes |

## Other

- **Enumeration date:** 01/22/2019
- **Last updated:** 09/08/2020