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Individual

MS. MARILYN FAYE BASS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
802 VILLETTE CT, BALLWIN, MO 63011-4142
(636) 256-2990
(636) 256-2990
Mailing address
802 VILLETTE CT, BALLWIN, MO 63011-4142
(636) 256-2990
(636) 256-2990

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW000341
MO

Other

Enumeration date
08/24/2005
Last updated
07/08/2007
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