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STEVEN A BACON BS

Individual Provider (NPI-1) Active

Behavior Technician

Provider Information

NPI Number
1902411879
Provider Type
Individual Provider (NPI-1)
Credentials
BS
Status
Active

Contact & Location

Address
8670 210TH ST W, LAKEVILLE, MN, 550447000
Phone
(800) 438-1772
Fax
(262) 345-5562

Specialties & Taxonomies

Behavior Technician Primary

All Addresses

LOCATION

8670 210TH ST W

LAKEVILLE, MN, 550447000

(800) 438-1772

MAILING

W175N11120 STONEWOOD DR

GERMANTOWN, WI, 530224799

(800) 438-1772