Olyvia Bacon
Behavior Technician in Westfield, IN. Individual provider (NPI-1).
NPI number1225835341
StatusActive
Last updated in NPPESFeb 26, 2025
Details
- NPI
- 1225835341
- Entity type
- Individual (NPI-1)
- Name
- Olyvia Bacon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 26, 2025
- Certification date
- Feb 26, 2025
- Last updated
- Feb 26, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | 23-287272 | IN | Yes |
Practice location
1143 E 181st StWestfield, IN 46074-8926
Phone 317-480-4002
Mailing address
1143 E 181st StWestfield, IN 46074-8926
Phone 317-480-4002
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