Individual
MARYIA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6705 PACIFIC AVE, FAYETTEVILLE, NC 28314-6520
(910) 257-1116
Mailing address
6705 PACIFIC AVE, FAYETTEVILLE, NC 28314-6520
(910) 257-1116
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2022
Last updated
06/27/2022
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