Provider Demographics
NPI:1295594182
Name:BASS, HAILEY RENEE (MT-BC)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:RENEE
Last Name:BASS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AMBLEWOOD DR APT D
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5328
Mailing Address - Country:US
Mailing Address - Phone:919-337-2442
Mailing Address - Fax:
Practice Address - Street 1:101 AMBLEWOOD DR APT D
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5328
Practice Address - Country:US
Practice Address - Phone:919-337-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist