Individual
LAURA STACEY BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6166 MARSH TRAIL DR, ODESSA, FL 33556-4438
(703) 980-1433
Mailing address
6166 MARSH TRAIL DR, ODESSA, FL 33556-4438
(703) 980-1433
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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