Provider Demographics
NPI:1770391336
Name:BASS, DEE ANN (MFT)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:ANN
Last Name:BASS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MALLORY STATION RD STE 110
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2825
Mailing Address - Country:US
Mailing Address - Phone:318-880-3858
Mailing Address - Fax:
Practice Address - Street 1:301 MALLORY STATION RD STE 110
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2825
Practice Address - Country:US
Practice Address - Phone:615-987-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist