Individual
AMANDA BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 AVIGNON DR STE 7, RIDGELAND, MS 39157-5166
(601) 454-3283
Mailing address
3428 LAMPTON AVE, JACKSON, MS 39213-5661
(601) 503-4904
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
04/08/2019
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