Individual
DR. JORDAN PAUL BACKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
85 1ST AVE, WALTHAM, MA 02451-1105
(781) 895-7963
Mailing address
85 1ST AVE, WALTHAM, MA 02451-1105
(781) 895-7963
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10520
MA
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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