Individual
HALEY ANN BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4840 GRASSELLI ST, EAST CHICAGO, IN 46312-3503
(219) 397-1085
Mailing address
1209 W MAIN ST, GRIFFITH, IN 46319-2620
(219) 765-2242
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-87862
IN
106E00000X
Assistant Behavior Analyst
0-25-16388
IN
106S00000X
Behavior Technician
RBT-23-305690
TN
Other
Enumeration date
03/06/2025
Last updated
03/09/2026
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