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1740781616
JEFFERSON BASS
WEST COLUMBIA, SC
NPI
1740781616
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: SC 17-45552)
Enumeration Date
2018-02-26
Last Update Date
2018-02-26
Business Address
JEFFERSON BASS
3115 SUNSET BLVD
WEST COLUMBIA, SC 29169-3425
Phone number: 803-791-3722
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Mailing Address
JEFFERSON BASS
181 W PROFESSIONAL PARK CT STE 1
BOWLING GREEN, KY 42104-3250
Phone number: 270-777-9283
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