National Provider Identifier

Kristen Canfield Bacon, OTD, MS, OTR/L

Kristen Canfield Bacon, OTD, MS, OTR/L is listed in the NPPES registry with a primary specialty of Occupational Therapist in Elmira, NY and a listed phone number of (607) 737-4100.

NPI 1174917561Elmira, NYOccupational Therapist

Profile Overview

NPI
1174917561
Provider Type
Individual
Primary Specialty
Occupational Therapist
Enumeration Date
March 24, 2015
Last Updated
March 24, 2015

Practice Location

  • 600 Roe Ave
  • Elmira, NY 14901

Phone: (607) 737-4100

Mailing Address

  • 3494 County Road 28
  • Watkins Glen, NY 14891-9748

Specialties

  • Occupational Therapist (225X00000X)
Full Record
NPI
1174917561
Entity Type
Individual
Last Name
Bacon
First Name
Kristen
Middle Name
Canfield
Name Prefix
Dr.
Credential
OTD, MS, OTR/L
Mailing Street Address
3494 County Road 28
Mailing City
Watkins Glen
Mailing State
NY
Mailing ZIP Code
14891-9748
Mailing Country
US
Practice Street Address
600 Roe Ave
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14901
Practice Country
US
Practice Phone
(607) 737-4100
Enumeration Date
March 24, 2015
Last Updated
March 24, 2015
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapist (225X00000X)