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1801669650
ROY RONALD BACON
FRESNO, CA
NPI
1801669650
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA SUDRC16662)
Enumeration Date
2023-11-02
Last Update Date
2023-11-02
Business Address
ROY RONALD BACON
4705 N SONORA AVE STE 113
FRESNO, CA 93722-3965
Phone number: 559-276-7558
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Mailing Address
ROY RONALD BACON
4705 N SONORA AVE STE 113
FRESNO, CA 93722-3965
Phone number: 559-276-7558
Copy
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