Diedra Lynne Bass, MSW
Individual provider Active NPI Social Worker · Spencer, OK
NPI 1972241537 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1972241537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 12716 NE 36TH St
Spencer, OK 73084-9167 - Phone
- (405) 769-3301
- Fax
- (405) 769-9685
- NPI assigned
- May 24, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
12716 NE 36TH St
Spencer, OK 73084-9167
Mailing address
PO Box 30589
Midwest City, OK 73140-3589
Phone (405) 769-3301
Other providers in Spencer, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.