Individual
MRS. KANDICE RENEE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
812 HIGHWAY 11 S, ELLISVILLE, MS 39437-3508
(601) 643-9815
Mailing address
7 JO RD, ELLISVILLE, MS 39437-4503
(601) 270-0663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1486
MS
101YM0800X
Mental Health Counselor
—
MS
101YP2500X
Professional Counselor
Primary
1486
MS
Other
Enumeration date
10/09/2007
Last updated
05/16/2025
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