Individual
BRANDY ELLEN BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
322 S BIRCH ST, MCCLEARY, WA 98557-9522
(360) 205-4750
Mailing address
BUSINESS MAILING ADDRESS, 322 S BIRCH ST, MCCLEARY, WA 98557
(360) 205-4750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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