Organization
BROOKSIDE WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLBY GANNON BACKMAN CMHC (PROGRAM DIRECTOR)
(435) 429-1042
Entity
Organization
Contact information
Practice address
4688 S WALLACE DR UNIT G, SAINT GEORGE, UT 84790-1863
(435) 429-1042
Mailing address
4688 S WALLACE DR UNIT G, SAINT GEORGE, UT 84790-1863
(435) 429-1042
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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