Individual
MRS. NANCY L BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
128 ORANGE ST, ANNA, IL 62906-1152
(618) 833-8997
(618) 833-9091
Mailing address
128 ORANGE ST, ANNA, IL 62906-1152
(618) 833-8997
(618) 833-9091
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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