Individual
MRS. MACHELLE OUTLAW BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1010 N BREAZEALE AVE UNIT C, UNIT E, MOUNT OLIVE, NC 28365-1106
(919) 658-7500
(919) 658-7509
Mailing address
191 FIVE POINTS RD, DUDLEY, NC 28333-5261
(919) 581-8198
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3563
NC
Other
Enumeration date
05/24/2006
Last updated
10/29/2013
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