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1184846818
JEAN LAROYCE BACON
BAY SHORE, NY
NPI
1184846818
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 045056-1)
Enumeration Date
2007-05-03
Last Update Date
2020-04-14
Business Address
Dr. JEAN LAROYCE BACON Ph.D.
83 E MAIN ST
BAY SHORE, NY 11706-8305
Phone number: 631-666-5067
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Mailing Address
Dr. JEAN LAROYCE BACON Ph.D.
34 FIRE ROAD DR
BAY SHORE, NY 11706-3947
Phone number: 631-834-0388
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