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1649576497
BREANNA L BACON
LAFAYETTE, IN
NPI
1649576497
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: IN 46002126A)
Enumeration Date
2011-01-26
Last Update Date
2014-07-07
Business Address
BREANNA L BACON MS CCC-SLP
80 PROFESSIONAL CT
LAFAYETTE, IN 47905-5152
Phone number: 765-448-1758
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Mailing Address
BREANNA L BACON MS CCC-SLP
80 PROFESSIONAL CT
LAFAYETTE, IN 47905-5152
Phone number: 765-448-1758
Copy
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