EDWARD BACON

DECATUR, IL
NPI1396252649
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: IL  180.011347)
Enumeration Date2018-01-09
Last Update Date2018-01-09
Business Address
EDWARD BACON LCPC
790 E MOUND RD
DECATUR, IL 62526-1951
Phone number: 309-323-8988
Mailing Address
EDWARD BACON LCPC
2552 LANSDOWNE DR
DECATUR, IL 62521-4972
Phone number:
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