Organization
JONATHAN BACKSTROM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON BACKSTROM LMHC (THERAPIST)
(563) 650-5863
Entity
Organization
Contact information
Practice address
2625 W 36TH ST, DAVENPORT, IA 52806-5224
(563) 650-5863
Mailing address
2625 W 36TH ST, DAVENPORT, IA 52806-5224
(563) 650-5863
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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