Individual
DR. JENNA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
635 W 165TH ST, 6TH FLOOR, EYE-6, NEW YORK, NY 10032-3724
(212) 305-9433
Mailing address
710 W 168TH ST FL 12, NEW YORK, NY 10032-3726
(212) 305-9758
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022214
NY
Other
Enumeration date
04/21/2017
Last updated
05/30/2018
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