Leslie Ann Bacon

Individual provider Active NPI Speech-Language Pathologist · Saint Joseph, MO

NPI 1760159784 · NPPES record last updated Aug 26, 2021

Key facts

NPI
1760159784
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2020001770 (MO)
Practice address
925 Felix St
Saint Joseph, MO 64501-2706
Phone
(816) 671-4000
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2020001770MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2020001770 MO Yes

Addresses

Primary practice location

925 Felix St
Saint Joseph, MO 64501-2706

Mailing address

925 Felix St
Saint Joseph, MO 64501-2706
Phone (816) 671-4000

Other providers in Saint Joseph, MO

All providers in Saint Joseph, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.