Individual
MS. ERIKA GORE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR-BC, LCMHC
Contact information
Practice address
16 KINGSFORD RD, HANOVER, NH 03755-2210
(603) 643-6013
(603) 646-9450
Mailing address
7 ROPE FERRY RD, HANOVER, NH 03755-1404
(603) 646-9442
(603) 646-9450
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000421
VT
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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