Individual
DERRIS ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3939 N ARLINGTON AVE, INDIANAPOLIS, IN 46226-4816
(463) 222-7550
Mailing address
8901 E 42ND ST, INDIANAPOLIS, IN 46226-5515
(463) 222-7550
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IN
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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