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Individual

JOHN BACKFISCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
19806 STATE HIGHWAY C, ADVANCE, MO 63730-8352
(573) 321-8924
Mailing address
19806 STATE HIGHWAY C, ADVANCE, MO 63730-8352
(573) 321-8924

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2022034386
MO
101YP2500X
Professional Counselor
Primary
2022034386
MO

Other

Enumeration date
08/10/2023
Last updated
05/06/2026
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