Individual
MR. THOMAS C BACKIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CCC-SLP
Contact information
Practice address
161 PARKWAY N, BREWER, ME 04412-1312
(207) 989-4337
Mailing address
PO BOX 1245, BANGOR, ME 04402-1245
(207) 989-4337
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
150
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043952
ANTHEM
ME
01
—
3343213
AETNA
ME
Enumeration date
03/08/2007
Last updated
07/09/2007
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