Individual
CONNIE MARIE BACKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
7580 160TH ST W, LAKEVILLE, MN 55044-8348
(952) 898-1133
(952) 435-6797
Mailing address
8060 250TH ST E, HAMPTON, MN 55031-9634
(612) 251-2518
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4383
MN
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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