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Individual

MS. DIANNE BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
140 SOUTH GILBERT ROAD, GILBERT, AZ 85296
(480) 497-3300
(480) 497-3340
Mailing address
2291 WEST PARK AVE, CHANDLER, AZ 85224
(480) 664-8920

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLPL4307
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLPL4307
AZ DEPT OF HEALTH SERVICE
AZ
Enumeration date
01/16/2007
Last updated
07/08/2007
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