Individual
JARED A BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BT
Contact information
Practice address
120 WYATT DR, LAS CRUCES, NM 88005-2925
(575) 526-6682
(575) 647-3777
Mailing address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(575) 526-6682
(575) 647-3777
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NM
Other
Enumeration date
08/04/2018
Last updated
08/04/2018
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