| NPI | 1174757066 |
|---|---|
| Former Name | JENNIFER DAWN BASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: OH 6250) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 6250) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2018-02-12 |