MEDICARE: CARMEA A BASS

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1902246994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEA A BASS

Provider Business Mailing Address
First Line	:	5920 LAVENDER BREEZE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6848
Country	:	US
Telephone Number	:	702-476-2777
Fax Number	:	702-848-2402

Provider Business Practice Location Address
First Line	:	5920 LAVENDER BREEZE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6848
Country	:	US
Telephone Number	:	702-475-6555
Fax Number	:	702-848-2402

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

Provider Enumeration Date	:	07/05/2013
Last Update Date	:	12/13/2020

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Directions to “ CARMEA A BASS ” Practice Location

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