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NPI Code Detail

MEDICARE: RENEA BASS

MEDICARE: RENEA 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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1073145587
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEA BASS
Provider Business Mailing Address
First Line : 6416 NW 5TH WAY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-6112
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-982-6491
Provider Business Practice Location Address
First Line : 20601 N 19TH AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-2666
Country : US
Telephone Number : 887-540-3988
Fax Number : 954-982-6491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2020
Last Update Date : 01/02/2024

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Directions to “ RENEA BASS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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