DEIDRA BASS

PORT SAINT LUCIE, FL
NPI1851749857
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: FL  900341538)
Enumeration Date2016-05-31
Last Update Date2016-05-31
Business Address
-- DEIDRA BASS
525 NW LAKE WHITNEY PL
PORT SAINT LUCIE, FL 34986-1605
Phone number: 772-446-1148
Mailing Address
-- DEIDRA BASS
525 NW LAKE WHITNEY PL
PORT SAINT LUCIE, FL 34986-1605
Phone number: 772-446-1148
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