Individual
ANTONETTE BACKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6491 BURKE RD, LAKE VIEW, NY 14085-9733
(716) 200-6828
Mailing address
6491 BURKE RD, LAKE VIEW, NY 14085-9733
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2770144
NY
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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