Provider Demographics
NPI:1659545010
Name:BASS, LORI A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:BASS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1664 N VIRGINIA ST
Mailing Address - Street 2:REDFIELD MEDICAL BLDG MS 152
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0001
Mailing Address - Country:US
Mailing Address - Phone:775-784-4887
Mailing Address - Fax:775-784-4095
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:REDFIELD MEDICAL BLDG MS 152
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-682-7029
Practice Address - Fax:775-784-7031
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1178235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist