JESSIE BACON, LCSW

Social Worker - Clinical

Active Individual
NPI: 1750507604

Practice Address

MISSION ROAD BLDING 248
FORT HALL INDIAN AGENCY
Fort Hall, ID 83203

Phone: (208) 237-5631

Specialties

Specialty Code Primary License
Social Worker - Clinical 1041C0700X Yes LCSW-32218 (ID)

Frequently Asked Questions

NPI 1750507604 is the National Provider Identifier for JESSIE BACON, LCSW, a Social Worker - Clinical provider located in Fort Hall, ID. This NPI was enumerated on April 18, 2007.
JESSIE BACON, LCSW practices at MISSION ROAD BLDING 248, FORT HALL INDIAN AGENCY, Fort Hall, ID 83203.

Quick Facts

NPI
1750507604
Type
Individual
Enumerated
Apr 18, 2007
Last Updated
Mar 18, 2024

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