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Individual
SAMANTHA ROSS
Active
Individual
SAMANTHA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112037
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUECROSS BLUESHIELD
—
05
—
0944746-02
—
TX
Enumeration date
09/30/2015
Last updated
09/30/2015
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