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Individual

MS. JILL E BACON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
6401 JAYCOX RD, NORTH RIDGEVILLE, OH 44039-1611
(440) 327-1800
(440) 327-1533
Mailing address
6401 JAYCOX RD, NORTH RIDGEVILLE, OH 44039-1611
(440) 327-1800
(440) 327-1533

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
6570
OH
103TC0700X
Clinical Psychologist
Primary
6570
OH

Other

Enumeration date
05/02/2007
Last updated
07/27/2023
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