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Individual

NANCY CAROLE BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
20 THE RAYS TRL SE, BOGUE CHITTO, MS 39629-8500
(601) 833-8363
(601) 833-0080
Mailing address
PO BOX 975, WESSON, MS 39191-0975
(601) 643-0153
(601) 833-0080

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2198
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0126674
MS
Enumeration date
08/14/2006
Last updated
07/09/2007
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