Susan Marie Back is a Psychologist in Jackson, Minnesota. Susan Marie Back practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Susan Marie Back is 1609952027. The last update date is 2007-07-08.
Susan Marie Back's current location address is Po Box 245, Jackson, Minnesota. You can contact this provider via phone number 5078475952 and fax number 5078475275. The mailing address for Susan Marie Back is Po Box 245, Jackson, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Marie Back |
|---|---|
| Address | Po Box 245, Jackson, Minnesota |
| Phone Number | 5078475952 |
| Fax Number | 5078475275 |
| Sole Proprietor | N |
| Credentials | MS LP |
NPI Number Detail
| NPI Number | 1609952027 |
|---|---|
| Provider Enumeration Date | 2006-10-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 245 |
|---|---|
| City | Jackson |
| State | Minnesota (MN) |
| Post Code | 56143 |
| Phone Number | 5078475952 |
| Fax Number | 5078475275 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | LP1191 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Post Comment/ Review Below
What is the unique identifier code issued to Susan Marie Back by the Centers for Medicare & Medicaid Services (CMS)?
The Susan Marie Back has been assigned the NPI (National Provider Identifier) 1609952027. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Susan Marie Back's facilities are situated?
The facilities of Susan Marie Back are physically located at the following address: Po Box 245, Jackson, MN, 56143.
What is the Susan Marie Back's specialty and taxonomy code?
The Susan Marie Back's specialty is Psychologist, and the corresponding taxonomy code is 103T00000X.
On what date did the Susan Marie Back receive its 1609952027 assignment from the Centers for Medicare & Medicaid Services?
The Susan Marie Back was assigned its 1609952027 by the Centers for Medicare & Medicaid Services on 2006-10-27.
When was the information regarding Susan Marie Back, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Susan Marie Back, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.