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MR. MICHAEL JANSON BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
1840 N 95TH AVE STE 132, PHOENIX, AZ 85037-4445
(623) 932-6950
Mailing address
2700 N CENTRAL AVE STE 1050, PHOENIX, AZ 85004-1217
(602) 376-3353

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN181884
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
291618
AZ

Other

Enumeration date
05/11/2023
Last updated
10/09/2024
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