Most Relevant Information
Provider Data
| NPI Number: | 1003509308 |
| Provider Name: | REBECCA JOY BACK LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 6801116334 |
Most Important Dates
| Enumeration Date: | 06/01/2023 |
| Last Updated: | 06/01/2023 |
Provider Practice Location
300 68TH ST SE
GRAND RAPIDS
MI
495486927
Practice Location Phone/Fax
| Phone: | 2699297342 |
| Fax: |
Provider Mailing Location
2520 POWERS AVE NW
GRAND RAPIDS
MI
495441866
Provider Mailing Phone/Fax
| Phone: | 2699297342 |
| Fax: |