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1821368077
DONNA TYESE BACON
AMITYVILLE, NY
NPI
1821368077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 070446)
Enumeration Date
2012-01-05
Last Update Date
2012-01-05
Business Address
Dr. DONNA TYESE BACON Ed.D, LCSW, MSW, CT
15 HARRISON AVE #1A
AMITYVILLE, NY 11701-2426
Phone number: 516-884-4802
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Mailing Address
Dr. DONNA TYESE BACON Ed.D, LCSW, MSW, CT
15 HARRISON AVE #1A
AMITYVILLE, NY 11701-2426
Phone number: 516-572-7528
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