Individual ProviderTheresa BassBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address421 Fayetteville St, Raleigh, NC 27601-1792(832) 964-4593PECOS EnrollmentBased on the most recent information from CMS, provider Theresa Bass does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1093301939Provider TypeIndividualFull NameBass, TheresaCredentialBSGenderFemaleSole ProprietorNoEnumeration Date12/15/2020Last Updated12/15/2020Contact InformationPractice LocationPractice Address421 Fayetteville St, Raleigh, NC 27601-1792PhoneUnlisted PhoneFaxUnlisted FaxMailing LocationMailing Address421 Fayetteville St Ste 1100, Raleigh, NC 27601-3000Phone(832) 964-4593FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer