Individual
JAVONTE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 WESTGATE DR STE 604, DURHAM, NC 27707-2534
(919) 493-5013
Mailing address
6605 LAKE HILL DR APT E, RALEIGH, NC 27609-3457
(252) 571-7142
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A12621
NC
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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