Individual
MIRANDA ANNE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
PO BOX 810, HANOVER, NH 03755-0810
(603) 308-1472
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2048
NH
231H00000X
Audiologist
A850
NH
237600000X
Audiologist-Hearing Aid Fitter
2048
NH
Other
Enumeration date
07/17/2024
Last updated
09/06/2024
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