Individual
REGINA JENEE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
747 SUMMIT ST STE A, WINSTON SALEM, NC 27101-1118
(336) 997-9029
Mailing address
5334 NORTHRIDGE DR, WINSTON SALEM, NC 27105-1787
(678) 704-7226
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11774
NC
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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