Individual
MRS. TAMIKA KENIECE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7826 WESTBROOK RD, LOUISVILLE, KY 40258-2682
(419) 386-4955
Mailing address
7826 WESTBROOK RD, LOUISVILLE, KY 40258-2682
(419) 386-4955
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/17/2024
Last updated
09/26/2024
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