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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Kelli Bahena
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All providers in Mena, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.