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Individual

MR. MAURICE PATRICK BACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCAC

Contact information

Practice address
201 NW 4TH ST, SUITE 107, EVANSVILLE, IN 47708-1350
(812) 422-6812
(812) 228-1113
Mailing address
201 NW 4TH ST, SUITE 107, EVANSVILLE, IN 47708-1350
(812) 422-6812
(812) 228-1113

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000738A
IN

Other

Enumeration date
03/13/2017
Last updated
03/13/2017
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