Individual
MARY JOYCE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 CHURCH ST STE 107, DECATUR, GA 30030-3330
(404) 861-2877
(855) 952-5859
Mailing address
87 ROGERS ST SE, ATLANTA, GA 30317-2237
(404) 861-2877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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