DERRICK BACON

PHILADELPHIA, PA
NPI1083102180
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2018-04-25
Last Update Date2018-04-25
Business Address
DERRICK BACON
906 69TH AVE
PHILADELPHIA, PA 19126-2909
Phone number: 215-300-8111
Mailing Address
DERRICK BACON
906 69TH AVE
PHILADELPHIA, PA 19126-2909
Phone number: 215-300-8111
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