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Individual

KIMBERLY BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CPCS

Contact information

Practice address
71 BLUE MOUNTAIN LN, ELLIJAY, GA 30536-6952
(122) 930-0864
Mailing address
71 BLUE MOUNTAIN LN, ELLIJAY, GA 30536-6952
(122) 930-0864

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005280
GA

Other

Enumeration date
04/22/2013
Last updated
02/06/2024
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