Individual
LORI BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
410 S AVALON ST, WEST MEMPHIS, AR 72301-4183
(870) 702-7300
(870) 702-7390
Mailing address
703 CALVIN AVERY DR, SUITE A, WEST MEMPHIS, AR 72301-6501
(870) 732-1878
(870) 702-7111
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/03/2012
Last updated
04/08/2016
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