Individual
KECIA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
561 HIDDEN LAKE DR, PROSPER, TX 75078-8782
(469) 767-2318
Mailing address
PO BOX 842, PROSPER, TX 75078-0842
(469) 767-2318
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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