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General NPI Number Information
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NPI Number | 1659992535
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Entity Type | Individual
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Provider Name | SONDRA MARIE ELIZABETH BASSO
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Gender | Female
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Dates
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Enumeration Date | 05/01/2020
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 1049 E NEWELL ST
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City | WHITE CLOUD
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State | MI
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Zip | 49349-8795
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Country | US
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Telephone | 231-689-7330
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Fax | 231-689-7345
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Provider Business Mailing Address
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Address Line | PO BOX 867
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City | WHITE CLOUD
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State | MI
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Zip | 49349-0867
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Country | US
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Telephone | 231-689-7330
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Fax | 231-689-7345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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