Individual
MRS. DIANNE BASS WAGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
101 FAIRVIEW PARK DR, DUBLIN, GA 31021-2501
(478) 272-7494
(478) 272-2616
Mailing address
101 FAIRVIEW PARK DR, DUBLIN, GA 31021-2501
(478) 272-7494
(478) 272-2616
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1187
GA
Other
Enumeration date
09/11/2006
Last updated
07/09/2007
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