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NPI Profile for RENEE L BACON in BRANFORD, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1114577012 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 09/13/2019 | |
| Last updated | 11/22/2024 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RENEE L BACON
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RENEE L BACON, LPC