Individual
ALYSSA BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7280 S 13TH ST STE 202, OAK CREEK, WI 53154-1831
(414) 929-5929
Mailing address
1419 E ALBION ST APT 1, MILWAUKEE, WI 53202-2335
(727) 514-2461
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
134382-121
WI
1041C0700X
Clinical Social Worker
Primary
134382-121
WI
Other
Enumeration date
07/12/2023
Last updated
01/06/2026
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