Individual
MS. DONNA R. BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5955 ZEAMER AVENUE, 673D MDG, JBER, AK 99506
(907) 580-8094
Mailing address
5955 ZEAMER AVENUE, 673D MDG, JBER, AK 99506
(907) 580-8094
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
387
AK
Other
Enumeration date
12/16/2005
Last updated
11/19/2013
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