Individual
TINA CHANTELLE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 COMEAUX RD, RAYVILLE, LA 71269-7554
(318) 303-5500
Mailing address
161 COMEAUX RD, RAYVILLE, LA 71269-7554
(318) 303-5500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-5752
LA
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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