Individual
EMMA M BASSO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
211B DELTA CT, TALLAHASSEE, FL 32303-4835
(850) 386-1560
(850) 386-4583
Mailing address
PO BOX 6227, TALLAHASSEE, FL 32314-6227
(850) 386-1560
(850) 386-4583
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW3662
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z6316
BCBS PROVIDER NUMBER
FL
Enumeration date
10/13/2005
Last updated
07/08/2007
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