Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS SUSAN MARIE BACK, MS LP
ActiveMISS SUSAN MARIE BACK, MS LP is a Psychologist healthcare provider located in JACKSON, Minnesota. NPI 1609952027 is currently active in the NPPES registry. Verify at CMS.
Psychologist · JACKSON, MN
Registration Details
- NPI Number
- 1609952027
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 27, 2006 (19.820564153959 yrs)
- Last Updated
- Jul 8, 2007
- License
-
LP1191 (MN)
Practice Information
- Address
-
116 COUNTY ROAD 34 WJACKSON, MN, 56143Browse MN providers · Browse ZIP 56143
- Phone
- 5078475952
- Fax
- 5078475275
- Primary Specialty
-
Psychologist
103T00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.