Individual
RONNIE BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1950 SPECTRUM CIR SE STE 145, MARIETTA, GA 30067-8470
(678) 921-2705
Mailing address
1950 SPECTRUM CIR SE STE 145, MARIETTA, GA 30067-8470
(678) 921-2705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
GA1950
GA
363A00000X
Physician Assistant
GA1950
GA
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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