Individual
KENNETH BACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED ADDICTION C
Contact information
Practice address
900 N BROADWAY STE 300, MINOT, ND 58703-2378
(701) 537-4191
(701) 786-7174
Mailing address
900 N BROADWAY STE 111, MINOT, ND 58703-2378
(701) 720-2964
(701) 786-7174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1973
ND
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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