Bacon, Victoria Lee

Bacon, Victoria Lee is an sole proprietor health care provider with primary practice located at 55 King Philip Rd , Norton MA 02766-3021. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Bacon, Victoria Lee can be contacted via phone (508) 285-4622.

Contact Information

Primary practice address
55 King Philip Rd Norton MA 02766-3021
Phone: (508) 285-4622
Fax: (508) 285-4622
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6597 Massachusetts
Behavioral Health & Social Service Providers / Health Service 103TH0100X 6597 Massachusetts

Profile Details

NPI number 1972669638
LBN Legal business name Bacon, Victoria Lee
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 28th, 2006
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972669638 NPPES
Massachusetts MEDICAID W05244

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