Individual
KIMBERLY ANN BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 ABBOTT DR, BROOMALL, PA 19008-4317
(888) 227-3898
(484) 471-5151
Mailing address
700 AVONDALE LN, SWARTHMORE, PA 19081-2107
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW132140
LSW
PA
Enumeration date
08/20/2018
Last updated
08/20/2018
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