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Individual
MRS. RAELYNN L. BASS
Active
Individual
MRS. RAELYNN L. BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC008217
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC008217
GA
101YM0800X
Mental Health Counselor
LPC008217
GA
101YP2500X
Professional Counselor
Primary
LPC008217
GA
106H00000X
Marriage & Family Therapist
LPC008217
GA
Other
Enumeration date
06/10/2014
Last updated
10/12/2016
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