Individual
JOANNA LYNN BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
707 BROADWAY BLVD NE, SUITE 103, ALBUQUERQUE, NM 87102-2360
(505) 766-9361
(505) 766-9157
Mailing address
707 BROADWAY BLVD NE, SUITE 103, ALBUQUERQUE, NM 87102-2360
(505) 766-9361
(505) 766-9157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0092051
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M0892
—
NM
Enumeration date
06/01/2009
Last updated
06/01/2009
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