Individual
DR. MICHAEL R BASSO
Active
Individual
DR. MICHAEL R BASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
800
OK
103TC0700X
Clinical Psychologist
800
OK
103TC0700X
Clinical Psychologist
Primary
LP6399
MN
2084P0800X
Psychiatry Physician
LP6399
MN
Other
Enumeration date
06/27/2005
Last updated
12/10/2020
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