Individual
LATOYA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6915 LAUREL BOWIE RD STE 205, BOWIE, MD 20715-1715
(240) 245-4370
(240) 245-4472
Mailing address
6915 LAUREL BOWIE RD STE 205, BOWIE, MD 20715-1715
(240) 245-4370
(240) 245-4472
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
04674
MD
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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