Individual
MONICA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42627 WYNSTONE DR, PRAIRIEVILLE, LA 70769-6396
(225) 363-0729
Mailing address
42627 WYNSTONE DR, PRAIRIEVILLE, LA 70769-6396
(225) 363-0729
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
LA
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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