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Individual

JAIME LEE BACON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
230 N 1680 E, STE T2, SAINT GEORGE, UT 84790-2573
(435) 652-2114
(435) 652-2132
Mailing address
230 N 1680 E, STE T2, SAINT GEORGE, UT 84790-2573
(435) 652-2114
(435) 652-2132

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
361006-3501
UT
1041C0700X
Clinical Social Worker
LCSW-11011
AZ

Other

Enumeration date
05/13/2007
Last updated
09/01/2017
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