EDWARD BACON LCPC
Individual Provider (NPI-1)
Active
Counselor, Professional
Provider Information
- NPI Number
1396252649- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LCPC
- Status
- Active
Contact & Location
- Address
- 790 E MOUND RD, DECATUR, IL, 625261951
- Phone
- (309) 323-8988
Specialties & Taxonomies
Counselor, Professional
Primary License: IL #180.011347
All Addresses
MAILING
2552 LANSDOWNE DR
DECATUR, IL, 625214972