Individual
MRS. LEAH MARIE BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
1441 MAIN ST, SUITE 900, SPRINGFIELD, MA 01103-1406
(603) 689-5825
(413) 224-2274
Mailing address
1441 MAIN ST, SUITE 900, SPRINGFIELD, MA 01103-1406
(603) 689-5825
(413) 224-2274
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
619
MA
Other
Enumeration date
05/29/2016
Last updated
05/29/2016
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