Individual
MISS LATORIA R BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
2411 ANITA ST, HOUSTON, TX 77004-3101
(504) 427-7005
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
088046
NY
1041C0700X
Clinical Social Worker
Primary
65899
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/04/2010
Last updated
08/31/2023
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