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1821630229
SAMUEL BACON
SPOKANE, WA
NPI
1821630229
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: WA CG61384091)
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2019-10-17
Last Update Date
2022-12-16
Business Address
SAMUEL BACON
107 S DIVISION ST
SPOKANE, WA 99202-1510
Phone number: 509-838-4651
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Mailing Address
SAMUEL BACON
107 S DIVISION ST
SPOKANE, WA 99202-1510
Phone number:
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