MEDICARE: MISS NINA BASSETT LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	9162	TX

General Provider Information

NPI Number	:	1679827976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NINA BASSETT LMT

Provider Business Mailing Address
First Line	:	2222 MARONEAL ST
Second Line	:	UNIT #1713
City	:	HOUSTON
State	:	TX
Zip	:	77030-3242
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 MARONEAL ST
Second Line	:	UNIT #1713
City	:	HOUSTON
State	:	TX
Zip	:	77030-3242
Country	:	US
Telephone Number	:	855-455-2229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2012
Last Update Date	:	11/08/2012

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Directions to “ MISS NINA BASSETT LMT” Practice Location

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