Individual
AMANDA M BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RMA
Contact information
Practice address
611 N STATE ST, STANTON, MI 48888-9702
(989) 831-7520
(989) 831-7578
Mailing address
611 N STATE ST, STANTON, MI 48888-9702
(989) 831-7520
(989) 831-7578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
374700000X
Technician
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
04/17/2026
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