person
Derrick Bacon
Mental Health Counselor in Philadelphia, Pennsylvania
NPI 1083102180

Derrick Bacon is a Mental Health Counselor based in Philadelphia, PA and is specialized in Mental Health. Derrick Bacon practices in Philadelphia, PA. The NPI Number for Derrick Bacon is 1083102180 and holds a License No. (Pennsylvania).

The current practice location address for Derrick Bacon is 906 69Th Ave, Philadelphia, PA and can be reached out via phone at 215-300-8111.

Location: 906 69Th Ave, Philadelphia, PA, 19126-2909
person
Provider Profile Details
NPI Number
1083102180
Provider Name
Derrick Bacon
Credential
Provider Entity Type
Individual
Gender
Male
Address
906 69Th Ave, Philadelphia, PA, 19126-2909
Phone Number
215-300-8111
Fax Number
Provider Enumeration Date
04/25/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
906 69Th Ave
City
State
Zip
19126-2909
Phone Number
215-300-8111
Fax Number
person
Provider Business Mailing Address Details
Address
906 69Th Ave
City
State
Zip
19126-2909
Phone Number
215-300-8111
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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