Provider Demographics
NPI:1043535594
Name:BASS, JULIA K (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:K
Last Name:BASS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WHIPPLE ST # 15
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5384
Mailing Address - Country:US
Mailing Address - Phone:401-305-8937
Mailing Address - Fax:401-205-2389
Practice Address - Street 1:9 WHIPPLE ST # 15
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-5384
Practice Address - Country:US
Practice Address - Phone:401-305-8937
Practice Address - Fax:401-205-2389
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-27
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILBA0003103K00000X
MALABA849103K00000X
1-04-1956103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty