Individual
BENJAMIN BACKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
251 MAIN ST STE 101, OLD SAYBROOK, CT 06475-2357
(860) 388-9656
Mailing address
140 MILL ST APT 533, EAST HAVEN, CT 06512-1071
(203) 671-0917
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
44.001308
CT
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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