Individual
KIMBERLEY ANNE BACKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E CHARLESTON BLVD STE 216, LAS VEGAS, NV 89104-1042
(702) 247-1145
Mailing address
7715 ORNAMENTO WAY, LAS VEGAS, NV 89179-1825
(702) 247-1145
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW87254
CA
104100000X
Social Worker
Primary
1358P-S
NV
Other
Enumeration date
01/22/2019
Last updated
09/08/2020
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