Individual
KAYLA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8407 S CONSTANCE AVE, CHICAGO, IL 60617-2218
(312) 721-2471
Mailing address
8407 S CONSTANCE AVE, CHICAGO, IL 60617-2218
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/24/2020
Last updated
12/24/2020
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