Healthcare Provider Details

I. General information

NPI: 1538338041
Provider Name (Legal Business Name): JULIA BASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 ZEIGLER CIR E
MOBILE AL
36608-4828
US

IV. Provider business mailing address

5750A SOUTHLAND DR
MOBILE AL
36693-3316
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-4335
  • Fax: 866-581-1527
Mailing address:
  • Phone: 251-450-5901
  • Fax: 251-662-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: