Individual
GIOVANNI AQUILLA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1601 HARMON AVE., FORT STEWART, GA 31324
(912) 435-6965
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C008797
NC
Other
Enumeration date
10/13/2014
Last updated
12/26/2017
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