Individual
AGNES BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1440 E SHERMAN BLVD STE 300, MUSKEGON, MI 49444-1816
(231) 672-2008
(231) 672-2009
Mailing address
PO BOX 776982, CHICAGO, IL 60677-6982
(231) 672-2119
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801100310
MI
Other
Enumeration date
09/09/2021
Last updated
03/01/2023
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