Individual
JESSICA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Mailing address
330 SUNDERLAND RD UNIT 56, WORCESTER, MA 01604-2528
(617) 645-9785
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9958
MA
Other
Enumeration date
12/20/2010
Last updated
08/18/2025
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