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General NPI Number Information
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NPI Number | 1720680192
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Entity Type | Individual
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Provider Name | JAMES BASS LMFT
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Gender | Male
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 920 18TH ST
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City | PLANO
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State | TX
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Zip | 75074-5831
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Country | US
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Telephone | 817-507-6451
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 MONTCLAIR DR
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City | CARROLLTON
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State | TX
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Zip | 75007-5511
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Country | US
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Telephone |
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203046
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License Number State | TX
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