Individual
DIEDRA LYNNE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
12716 NE 36TH ST, SPENCER, OK 73084-9167
(405) 769-3301
(405) 769-9685
Mailing address
PO BOX 30589, MIDWEST CITY, OK 73140-3589
(405) 769-3301
(405) 769-9685
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/24/2022
Last updated
05/24/2022
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