Bacon, Amy L.
Bacon, Amy L. is an sole proprietor health care provider with primary practice located at 316 Upland Dr , Lafayette LA 70506-6852. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Bacon, Amy L. can be contacted via phone (337) 344-5407.Contact Information
Primary practice address
316 Upland Dr
Lafayette LA 70506-6852
Phone: (337) 344-5407
Fax: (334) 344-5407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 5135 | Louisiana |
Profile Details
| NPI number | 1245367176 |
|---|---|
| LBN Legal business name | Bacon, Amy L. |
| Credentials | MS, CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Feb 20th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245367176 | NPPES |
| Louisiana | MEDICAID | 1472221 |
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