Most Relevant Information
Provider Data
NPI Number: | 1003469818 |
Provider Name: | SUSAN ROBIN BASS LPC |
Entity Type: | Individual |
Taxonomy Code: | 101YP2500X |
Specialty: | Counselor |
License Number: | 002008 |
Most Important Dates
Enumeration Date: | 07/20/2019 |
Last Updated: | 07/20/2019 |
Provider Practice Location
27 MAIN ST
HEBRON
CT
062481514
Practice Location Phone/Fax
Phone: | 8602281287 |
Fax: |
Provider Mailing Location
17 HERITAGE RD
COLUMBIA
CT
062371047
Provider Mailing Phone/Fax
Phone: | 8609424924 |
Fax: |