Provider Demographics
NPI:1033456421
Name:BACKHUS, KATHERINE (MS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BACKHUS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 LAWNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-4728
Mailing Address - Country:US
Mailing Address - Phone:865-376-3464
Mailing Address - Fax:865-376-7982
Practice Address - Street 1:1324 LAWNVILLE RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4728
Practice Address - Country:US
Practice Address - Phone:865-376-3464
Practice Address - Fax:865-376-7982
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health