Individual
KRISTINA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
716 E BELLA VISTA ST, LAKELAND, FL 33805-3009
(863) 683-6504
Mailing address
3208 HURLEY GROVE WAY, VALRICO, FL 33596-5674
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16830
FL
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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