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1952016701
JENNIE BACON
MERIDIAN, ID
NPI
1952016701
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: ID LPC-8077)
Enumeration Date
2023-01-17
Last Update Date
2023-01-17
Business Address
JENNIE BACON
1519 N MAIN ST # 110
MERIDIAN, ID 83642-1717
Phone number: 208-724-8284
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Mailing Address
JENNIE BACON
1628 S LOGGERS POND PL APT 13
BOISE, ID 83706-6599
Phone number: 208-724-8284
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