Individual
AMY MARIE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
4380 W 12TH ST STE 2F, ERIE, PA 16505-3028
(814) 580-6166
Mailing address
238 WILCOX ST, GIRARD, PA 16417-1340
(814) 218-5194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC001309
PA
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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