Stacee Nicole Bacon, MS CF-SLP

Individual provider Active NPI Speech-Language Pathologist · Mena, AR

NPI 1811535883 · NPPES record last updated Dec 20, 2019

Key facts

NPI
1811535883
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
311 Morrow St N
Mena, AR 71953-2516
Phone
(479) 394-6100
NPI assigned
Dec 20, 2019
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
Credentials
Master of Science

Specialties & licenses

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

Addresses

Primary practice location

311 Morrow St N
Mena, AR 71953-2516

Mailing address

311 Morrow St N
Mena, AR 71953-2516
Phone (479) 394-6100

Other providers in Mena, AR

All providers in Mena, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.