Individual
JAHAYRA PANTELOGLOUS BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 N MAIN ST, CULPEPER, VA 22701-2609
(540) 727-0770
(540) 727-7310
Mailing address
605 N MAIN ST, CULPEPER, VA 22701-2609
(540) 727-0770
(540) 727-7310
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701008825
VA
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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