Individual
CASSIDY LAURIN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
890 BURRUS RD, MACON, GA 31204-1441
(478) 330-7164
(478) 330-7167
Mailing address
154 TURNERWOODS RD, GRAY, GA 31032-5632
(478) 234-9882
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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